Individual provider Active NPI

John M Blough, D.O.

  • Family Medicine Physician
  • Troy, AL
National Provider Identifier
1972513059
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO-601 Issued in AL
Practice address
1412 Elba Hwy
Troy, AL 36079-0000
Phone
(334) 566-8822
Fax
(334) 670-6723
NPI assigned
Aug 9, 2006
Last updated
Mar 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO-601 AL Primary

Addresses

Primary practice location

1412 Elba Hwy
Troy, AL 36079-0000

Mailing address

1412 Elba Hwy
Troy, AL 36079-0000
Phone (334) 566-8822

Other identifiers 2

IdentifierTypeStateIssuer
51530670OtherALBCBS
631804037MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO-601ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medexpress Red Bay LLC Current Accepting new patients
HH Health System - Shoals LLC Current Accepting new patients
Heart Health Center PC Past Accepting new patients
United Florala, Inc Past Accepting new patients
Colbert Co Northwest Al Healthcare Authority Family Medicine Past Accepting new patients

Locations

211 Hospital Rd
Red Bay, AL 35582
Phone (256) 356-8160

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1972513059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 ELBA HWY",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360790000",
            "telephone_number": "334-566-8822",
            "fax_number": "334-670-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 ELBA HWY",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360790000",
            "telephone_number": "334-566-8822",
            "fax_number": "334-670-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOUGH",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO-601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51530670",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "631804037",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.