Nicole L Blust, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6309 Issued in OH

Practice address

7755 Paragon Rd
Suite 102
Dayton, OH 45459-4055

Phone

(937) 567-7800

Fax

(937) 567-7808

NPI assigned

Jul 10, 2007

Last updated

Feb 1, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Oct 1, 2014 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Dr. Nicole L. Blust, LLC

  • Psychologist
  • Dayton, OH
  • NPI 1578765400
  Authorized official Same address or phone

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1659579803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7755 PARAGON RD",
            "address_2": "SUITE 102",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594055",
            "telephone_number": "937-567-7800",
            "fax_number": "937-567-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7755 PARAGON RD",
            "address_2": "SUITE 102",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594055",
            "telephone_number": "937-567-7800",
            "fax_number": "937-567-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUST",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "6309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bluemed LLC
• Amber Blumenstock, RNBSN
• Steven John Blumhof, D.O.
• Erica Marie Blumke, APRN, AGNP-C
• Emilea Blunt
• Dezanee Bluthenthal
• Kimberly A Blythe
• Terriona Necco Blythe
• Jeanne Boardman
• Dana Renee Bobalik, LSW

• Psychologist in Dayton, OH
• Providers in Dayton, OH by specialty
• Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.