Individual provider Active NPI

Steven William Blum, PA C FNP C

  • Medical Physician Assistant
  • Charles City, IA
National Provider Identifier
1629060801
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000828 Issued in IA
Practice address
1501 S Main St Ste 6
Charles City, IA 50616-3444
Phone
(641) 228-5151
Fax
(641) 228-2902
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000828 IA Primary

Addresses

Primary practice location

1501 S Main St Ste 6
Charles City, IA 50616-3444

Mailing address

1501 S Main St Ste 6
Charles City, IA 50616-3444
Phone (641) 228-5151

Other identifiers 1

IdentifierTypeStateIssuer
970008132OtherRR MEDICARE

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)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charles City Family Health Ctr, P.C. CurrentSince Sep 1, 1991 Accepting new patients

Locations

1501 S Main St
Ste 1
Charles City, IA 50616
Phone (515) 228-5151

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1629060801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S MAIN ST STE 6",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506163444",
            "telephone_number": "641-228-5151",
            "fax_number": "641-228-2902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S MAIN ST STE 6",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506163444",
            "telephone_number": "641-228-5151",
            "fax_number": "641-228-2902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "STEVEN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PA C FNP C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "000828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "970008132",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2017; 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.