Healthcare Provider Details

I. General information

NPI: 1467927483
Provider Name (Legal Business Name): BLUEPRINT HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2018
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 SUMMER ST
FITCHBURG MA
01420-5761
US

IV. Provider business mailing address

PO BOX 100
MIDDLETON MA
01949-0100
US

V. Phone/Fax

Practice location:
  • Phone: 781-609-3222
  • Fax: 781-819-0049
Mailing address:
  • Phone: 781-609-3222
  • Fax: 781-819-0049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AKINDELE MAJEKODUNMI
Title or Position: CEO/ OWNER
Credential: MD
Phone: 267-779-5939