James Wallentine Blotter, M.D.

Primary specialty

Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X

License

3082587-1205 Issued in UT

Practice address

2245 N 400 E
Ste 301
North Logan, UT 84341-1892

Phone

(435) 753-7880

Fax

(435) 753-5845

NPI assigned

Sep 29, 2005

Last updated

Mar 7, 2023By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT, ID2 enrollments

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 2

Specialty

Otolaryngology

Education

University of Utah School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cache Valley Ear Nose and Throat, PLLCGroup PAC ID 5193128882, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015
• Bear Lake Memorial Hospital Hospital, Montpelier, ID, CCN 131316
• Cache Valley Hospital Hospital, North Logan, UT, CCN 460054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Cache Valley Ear Nose & Throat, PLLC

  dba Cache Valley Ear Nose and Throat.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • North Logan, UT
  • NPI 1548303795

  ID

  Medicare reassignment Care Compare group
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  dba Intermountain Health Logan Regional Hospital

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation
• Mountain Division - CVH, LLC

  dba Cache Valley Hospital

  • General Acute Care Hospital
  • North Logan, UT
  • NPI 1952703472
  Care Compare affiliation
• Bear Lake County Memorial Hospital

  • Critical Access Hospital
  • Montpelier, ID
  • NPI 1336125533
  Care Compare affiliation

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1962499673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 N 400 E",
            "address_2": "STE 301",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411892",
            "telephone_number": "435-753-7880",
            "fax_number": "435-753-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 N 400 E",
            "address_2": "STE 301",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411892",
            "telephone_number": "435-753-7880",
            "fax_number": "435-753-5845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2380 N 400 E",
            "address_2": "Suite #D",
            "address_purpose": "LOCATION",
            "city": "North Logan",
            "state": "UT",
            "postal_code": "843411749",
            "country_code": "US",
            "telephone_number": "435-753-7880",
            "fax_number": "435-753-5845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOTTER",
        "first_name": "JAMES",
        "middle_name": "WALLENTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2023-03-07",
        "certification_date": "2022-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "UT",
            "license": "3082587-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO STATE LICENSE",
            "identifier": "M-8784",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87037196400",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Call Baugh, PA-C
• Bear Lake Community Health Center, Inc. (Cache Valley Community Health Center)
• Jeffrey Green Bennion, M.D.
• Caitlin Sayard Benvenuti
• Bradley Pope Bills, D.D.S., P.C.
• Andrea Ellis Bott
• Paul Tucker Bradley, PHARM. D.
• Bright Sage Psychology LLC
• Bruce Lundin OD LLC
• Cedric Buckley, D.O.

• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in North Logan, UT
• Providers in North Logan, UT by specialty
• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.