Active NPI
David Blossom, PHARMD
- Pharmacist
- Soldotna, AK
National Provider Identifier
1457740037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 2282
- Practice address
- 299 N Binkley St
Soldotna, AK 99669-7523 - Phone
- (907) 262-3800
- NPI assigned
- Jan 20, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 2282 | AK | Primary |
Addresses
Primary practice location
299 N Binkley St
Soldotna, AK 99669-7523
Mailing address
22525 Julie Dr
Kasilof, AK 99610
Phone (907) 398-7137
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2282 | AK | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421712000000",
"number": "1457740037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22525 JULIE DR",
"city": "KASILOF",
"state": "AK",
"postal_code": "99610",
"telephone_number": "907-398-7137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "299 N BINKLEY ST",
"city": "SOLDOTNA",
"state": "AK",
"postal_code": "996697523",
"telephone_number": "907-262-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLOSSOM",
"first_name": "DAVID",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-20",
"last_updated": "2015-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AK",
"license": "2282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Soldotna, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.