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ETHAN RANDALL BLOMBERG NREMT-P
NPI 1902740715
Emergency Medical Technician, Paramedic in Fort Campbell, KY

Active since April 14, 2026
6103 WICKHAM AVE, FORT CAMPBELL, KY 42223(715) 657-0985 Get Directions Write a Review

NPPES record last updated: April 14, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ethan Randall Blomberg Nremt-p NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN RANDALL BLOMBERG NREMT-P (NPI 1902740715) is an individual emergency medical technician, paramedic in Fort Campbell, Kentucky, licensed in Georgia (P032566) and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1902740715
Entity TypeIndividualMale
Primary Taxonomy146L00000X
Provider Legal NameETHAN RANDALL BLOMBERGCredential: NREMT-P
Location Address6103 WICKHAM AVEFort Campbell, KY 42223-5425
Mailing Address6103 Wickham AveFort Campbell, KY 42223-5425 · (715) 657-0985
Phone(715) 657-0985
Sole ProprietorNo
Enumeration DateApril 14, 2026
NPPES CertifiedApril 14, 2026
✔ NPI 1902740715 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency Medical Technician, ParamedicEmergency Medical Service Providers
Taxonomy Code146L00000X
License✔ Licensed in GA · P032566
Definition
An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards.
6103 WICKHAM AVE, Fort Campbell, KY 42223
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Blomberg's NPI number?

The NPI number for Ethan Blomberg is 1902740715. It was assigned to this individual provider in the NPPES registry on April 14, 2026.

Where is Ethan Blomberg located?

Ethan Blomberg practices at 6103 Wickham Ave, Fort Campbell, KY 42223. The listed phone number is (715) 657-0985.

What is Ethan Blomberg's specialty?

The primary specialty registered for this NPI is Emergency Medical Technician, Paramedic with taxonomy code 146L00000X.

When was this NPI record last updated?

The NPPES record for Ethan Blomberg was last updated on April 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.