Gary Lee Blunk, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

1394 Issued in CO

Practice address

2373 G Rd
Suite 200
Grand Junction, CO 81505-9641

Phone

(970) 243-3061

Fax

(970) 245-8369

NPI assigned

Sep 27, 2006

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Community Medical Group, LLC

  • Family Medicine Physician
  • Grand Junction, CO
  • NPI 1629201637
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400198400000",
    "number": "1891886503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2373 G RD",
            "address_2": "SUITE 200",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815059641",
            "telephone_number": "970-243-3061",
            "fax_number": "970-245-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 G RD",
            "address_2": "SUITE 200",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815059641",
            "telephone_number": "970-243-3061",
            "fax_number": "970-245-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUNK",
        "first_name": "GARY",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2014-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "1394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Surgical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.