JK Blixt D.O. Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

38650 Issued in CO

Legal business name

JK BLIXT D.O. INC

Practice address

1715 N Weber St Ste 260
Colorado Springs, CO 80907-7553

Phone

(719) 896-4794

Fax

(719) 896-5484

NPI assigned

Oct 15, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Blixt, DO,FASAM

Title

Doctor

Phone

(719) 896-4794

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1619129269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 N WEBER ST STE 260",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077553",
            "telephone_number": "719-896-4794",
            "fax_number": "719-896-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 N WEBER ST STE 260",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077553",
            "telephone_number": "719-896-4794",
            "fax_number": "719-896-5484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "417 Security Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "80911",
            "country_code": "US",
            "telephone_number": "719-392-1441",
            "fax_number": "719-392-6044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JK BLIXT D.O. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "BLIXT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "719-896-4794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO,FASAM"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "38650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17204062",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.