Peter Frederick Blomgren, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21535 Issued in NC

Practice address

317 W Wendover Ave
Greensboro, NC 27408-8401

Phone

(336) 373-1794

Fax

(336) 373-0505

NPI assigned

Dec 19, 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

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Family Practice

Education

Indiana University School of Medicine, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Peter F Blomgren MD PLLC

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1043651664
  Medicare reassignment NPD Authorized official
• P F Blomgren & D C Keller PTR

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1326102021
  NPD (past) Authorized official

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

• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1962565085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 W WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088401",
            "telephone_number": "336-373-1794",
            "fax_number": "336-373-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W WENDOVER AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088401",
            "telephone_number": "336-373-1794",
            "fax_number": "336-373-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOMGREN",
        "first_name": "PETER",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "21535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "16316",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0102582",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080098543",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8916316-20",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cooper Mark Blevins
• Douglas Dane Blevins, MD
• Melinda Ann Blietz, MD
• Amber Paylor Bliss, MS, LCMHC
• Timothy Dwayne Blocker, CRNA
• Gustav Arthur Blomquist Jr., MD
• Mitchell Bloom, M.D.
• Brannon Elizabeth Blount, MS, RDN
• Keleigh Blount, LPC-A, NCC, CCMHC
• Blue Angels Healthcare Services.LLC

• Family Medicine Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.