Jim D Blunk, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

05-19457 Issued in KS

Practice address

415 S Osage St
Caldwell, KS 67022-1650

Phone

(620) 845-2516

Fax

(620) 845-2518

NPI assigned

Jul 26, 2005

Last updated

Feb 8, 2018By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bass Memorial Baptist Hospital

  dba Integris Bass Baptist Health Center

  • Family Medicine Physician
  • Cherokee, OK
  • NPI 1326040817
  NPD (past)
• Bass Memorial Baptist Hospital Dba Integris Bass Baptist Health Center

  dba Advance Food Company Employee's Medical Clinic

  • Primary Care Clinic/Center
  • Enid, OK
  • NPI 1053327486
  NPD (past)
• Integris Bass Baptist Health Center

  dba Parrish Enterprises Employee's Medical Clinic

  • Primary Care Clinic/Center
  • Enid, OK
  • NPI 1134499338
  NPD (past)
• Integris Bass Baptist Health Center

  dba Integris Health Enid Hospital

  • General Acute Care Hospital
  • Enid, OK
  • NPI 1144236571
  NPD (past)

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1962402537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "620-845-2516",
            "fax_number": "620-845-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S OSAGE ST",
            "city": "CALDWELL",
            "state": "KS",
            "postal_code": "670221650",
            "telephone_number": "620-845-2516",
            "fax_number": "620-845-2518"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 S Osage St",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "KS",
            "postal_code": "670221650",
            "country_code": "US",
            "telephone_number": "620-845-2516",
            "fax_number": "620-845-2518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUNK",
        "first_name": "JIM",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "2082",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "05-19457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Grace Balman
• Karissa Bratcher, PHARMD
• Caldwell Compounding Pharmacy Inc (Caldwell Pharmacy)
• Caldwell Pharmacy Inc (Caldwell Pharmacy LTC)
• Caldwell Pharmacy Inc (Caldwell Pharmacy)
• Goodrick Home Care

• Family Medicine Physician in Caldwell, KS
• Providers in Caldwell, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.