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KORY BLUMER
Complete NPI Record 1750641312
Speech-Language Pathologist in Roscoe, IL

NPI Status: Active since May 16, 2012

Contact Information

10440 MONARCH RD UNIT 1
ROSCOE, IL
ZIP 61073
Phone: (608) 293-0136

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Provider Gender Code
  20. Healthcare Provider Taxonomy Code 1
  21. Provider License Number 1
  22. Provider License Number State Code 1
  23. Healthcare Provider Primary Taxonomy Switch 1
  24. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1750641312. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1750641312
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: KORY
The first name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address: 10440 MONARCH RD UNIT 1
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: ROSCOE
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: IL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 610738845
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Business Mailing Address Telephone Number: 6082930136
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider First Line Business Practice Location Address: 10440 MONARCH RD UNIT 1
The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Practice Location Address City Name: ROSCOE
The city name in the mailing address of the provider being identified.
Provider Business Practice Location Address State Name: IL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Practice Location Address Postal Code: 610738845
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Practice Location Address Telephone Number: 6082930136
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Enumeration Date: 5/16/2012
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Last Update Date: 5/16/2012
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Gender Code: F
The city name in the location address of the provider being identified.
Healthcare Provider Taxonomy Code 1: 235Z00000X
The State code in the location of the provider being identified.
Provider License Number 1: 242.002016
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider License Number State Code 1: IL
The country code in the location address of the provider being identified.
Healthcare Provider Primary Taxonomy Switch 1: Y
The telephone number associated with the location address of the provider being identified.
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No