David Blaisdell, CPO, LPO

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

PS00000468 Issued in WA

Practice address

949 Stevens Dr
Richland, WA 99352-3508

Phone

(509) 946-2520

Fax

(509) 946-2530

NPI assigned

Mar 24, 2014

Last updated

Mar 24, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395619200000",
    "number": "1578980991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "949 STEVENS DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523508",
            "telephone_number": "509-946-2520",
            "fax_number": "509-946-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 STEVENS DR",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523508",
            "telephone_number": "509-946-2520",
            "fax_number": "509-946-2530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "DAVID",
        "credential": "CPO, LPO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WA",
            "license": "PS00000468",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "WA",
            "license": "OI00000469",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Richland, WA
• Providers in Richland, WA by specialty
• Prosthetic/Orthotic Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.