Ethan Randall Blomberg, NREMT-P

Primary specialty

ParamedicTaxonomy code 146L00000X

License

P032566 Issued in GA

Practice address

6103 Wickham Ave
Fort Campbell, KY 42223-5425

Phone

(715) 657-0985

NPI assigned

Apr 14, 2026

Last updated

Apr 14, 2026By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1776124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1902740715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6103 WICKHAM AVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235425",
            "telephone_number": "715-657-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6103 WICKHAM AVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235425",
            "telephone_number": "715-657-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOMBERG",
        "first_name": "ETHAN",
        "middle_name": "RANDALL",
        "credential": "NREMT-P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "GA",
            "license": "P032566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blanchfiled Army Community Hospital
• Amy A Blank, CCC-A
• Leonta F Blankenship, BSN
• Donald McLain Blanton, MD
• Alice Sachiko Blizman
• Natalie Nicole Bobay, DMD
• Andrew J Bodwell, O.D.
• John Ryan Boesch, RD
• Lena Bond
• Zachary C. Booms, D.O.

• Paramedic in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Paramedic in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; 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.