MR. JUSTIN DAVID BLYTHE JR.
NPI 1669293890
Registered Nurse - Neuroscience in Park Ridge, IL

NPI Status: Active since October 21, 2024

Contact Information

1875 DEMPSTER ST STE 625
PARK RIDGE, IL
ZIP 60068
Phone: (847) 723-4088
Fax: (847) 627-8700

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  • Individual
  • Male
  • Years of Experience 1
  • Registered Nurse
  • Neuroscience
  • May Accept Medicare Approved Payment
  • PECOS Enrolled

About JUSTIN BLYTHE

This page provides the complete NPI Profile along with additional information for Justin Blythe, a provider established in Park Ridge, Illinois with a medical specialization in Registered Nurse, focusing in neuroscience and more than one year of experience. The healthcare provider is registered in the NPI registry with number 1669293890 assigned on October 2024. The practitioner's primary taxonomy code is 163WN0800X with license number 041548967 (IL). The provider is registered as an individual and his NPI record was last updated one year ago.

NPI
1669293890
Provider Name
MR. JUSTIN DAVID BLYTHE JR.
Gender
Male
Entity Type
Individual
Location Address
1875 DEMPSTER ST STE 625 PARK RIDGE, IL 60068
Location Phone
(847) 723-4088
Location Fax
(847) 627-8700
Mailing Address
29373 NETWORK PL CHICAGO, IL 60673
Mailing Phone
(847) 390-5900
Medical School Name
OTHER
Graduation Year
2025
Is Sole Proprietor?
Yes
Enumeration Date
10-21-2024
Last Update Date
10-21-2025
Code Navigator

A registered nurse (RN) like Justin Blythe coordinates and provides patient care and educates patients about various health conditions. Registered nurses give advice and emotional support to patients and their families. The typical duties of a registered nurse include: assessing patient conditions, record medical histories and symptoms, observe patients and record the observations, administer medicines and treatments, consult and collaborate with doctors, operate and monitor medical equipment, teach patients and families how to manage injuries or illnesses, etc.

Registered nurses typically work as part of a team with physicians and other healthcare professionals. In some medical teams registered nurses supervise nursing assistants, licensed practical nurses, and home health aides.

Location Map

Secondary Locations

  • 801 S Milwaukee Ave
    Libertyville, IL 60048
    (847) 990-5666

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Registered Nurse Neuroscience

Taxonomy Code
163WN0800X
Type
Nursing Service Providers
License No.
041548967
License State
IL

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363L00000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner

209-032573 (IL)
2363LF0000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Family

209-032573 (IL)

Medicare Participation & PECOS Enrollment Status

Justin Blythe is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.

Justin Blythe is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6204331747

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20250925000630

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Maybe

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1669293890, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 80. The final step is to find the difference between that total and the next multiple of ten (80 - 80 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
9
Unchanged
Pos 5
2
Doubled → 4
Pos 6
9
Unchanged
Pos 7
3
Doubled → 6
Pos 8
8
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 2 → 4 3 → 6 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 2 + 9 + 4 + 9 + 6 + 8 + 1 + 8 + 24 = 80

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 80 is 80. The difference is the calculated check digit.

80 - 80 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1669293890.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Specialist
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Physician Assistant
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Nurse Practitioner (Family)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Nurse Practitioner
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Vascular Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurocritical Care)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Nurse Practitioner
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068
Psychiatry & Neurology (Neurology)
1875 DEMPSTER ST STE 625
PARK RIDGE, IL 60068

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1669293890, enumerated as an "individual" on October 21, 2024.

The provider is located at 1875 DEMPSTER ST STE 625 PARK RIDGE, IL 60068 and the phone number is (847) 723-4088.

Registered Nurse with taxonomy code 163WN0800X and a focus in Neuroscience.