Individual provider Active NPI

Karen Anne Blundon, PA-C

  • Physician Assistant
  • Springfield, OR
National Provider Identifier
1447561899
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA152196 Issued in OR
Practice address
2073 Olympic St
Springfield, OR 97477-3413
Phone
(541) 682-3550
Fax
(541) 682-3551
NPI assigned
Jun 30, 2010
Last updated
Jan 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA152196 OR Primary
Medical Physician Assistant 363AM0700X PA152196 OR

Addresses

Primary practice location

2073 Olympic St
Springfield, OR 97477-3413

Mailing address

2073 Olympic St
Springfield, OR 97477-3413
Phone (541) 682-3550

Other names 1

  • Karen Anne Cogswell Bolduc Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110301000726 OR Practitioner - Physician Assistant 0042491748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lane County OregonGroup PAC ID 7416853833, 31 clinicians

Practice addresses (Care Compare)

1022 Green Acres Rd
Eugene, OR 97408-6501
Phone (541) 682-3550

2073 Olympic St
Springfield, OR 97477-3413
Phone (541) 682-3550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA152196ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lane County Oregon CurrentSince Jan 20, 2015 Accepting new patients

Locations

1022 Green Acres Rd
Eugene, OR 97408
Phone (541) 682-7206

2073 Olympic St
Springfield, OR 97477
Phone (541) 682-3530

Interoperability endpoints

  • Direct secure messaging: karen.blundon.p1@direct.lanecounty.nextgenshare.com
  • Direct secure messaging: kblundon684143@direct.ochin.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1447561899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2073 OLYMPIC ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773413",
            "telephone_number": "541-682-3550",
            "fax_number": "541-682-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2073 OLYMPIC ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773413",
            "telephone_number": "541-682-3550",
            "fax_number": "541-682-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUNDON",
        "first_name": "KAREN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA152196",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA152196",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "BOLDUC",
            "middle_name": "ANNE COGSWELL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, OR

Sources for this page

Verify at the official NPI Registry.