Blaze Community Services LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

BLAZE COMMUNITY SERVICES LLC

Practice address

136 E. Spring St.
Clayton, OH 45315

Phone

(937) 409-1209

NPI assigned

Dec 10, 2020

Last updated

Dec 10, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brent Allan Davis

Title

President

Phone

(937) 409-1209

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1740886183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 165",
            "city": "CLAYTON",
            "state": "OH",
            "postal_code": "453150165",
            "telephone_number": "937-409-1209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E. SPRING ST.",
            "city": "CLAYTON",
            "state": "OH",
            "postal_code": "45315",
            "telephone_number": "937-409-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAZE COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-409-1209"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gregory C. Behrens, ATC
• Shaundra Janelle Blair, OTD, OTR/L, CDP
• Rebecca Brand, RN
• Andrea Burns, APRN
• Hillary Campbell, STNA
• Grace Patricia Counts
• Katherine L Davis, PT

• Non-emergency Medical Transport (VAN) in Clayton, OH
• Providers in Clayton, OH by specialty
• Non-emergency Medical Transport (VAN) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.