Individual provider Active NPI

Kelin Scott Bleazard, MD

  • Emergency Medicine Physician
  • Toledo, OH
National Provider Identifier
1932993284
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
57.257978 Issued in OH
Practice address
2213 Cherry St
Toledo, OH 43608-2603
Phone
(419) 251-4724
Fax
(419) 251-2698
NPI assigned
Apr 9, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 57.257978 OH Primary

Addresses

Primary practice location

2213 Cherry St
Toledo, OH 43608-2603

Mailing address

2213 Cherry St
Toledo, OH 43608-2603
Phone (419) 251-4724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250808000244 OH Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 3476051558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1932993284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-4724",
            "fax_number": "419-251-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2213 CHERRY ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436082603",
            "telephone_number": "419-251-4724",
            "fax_number": "419-251-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEAZARD",
        "first_name": "KELIN",
        "middle_name": "SCOTT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "57.257978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.