=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639210552
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTOPHER R BLUE MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2007
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3243 E MURDOCK ST SUITE 201
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67208-3052
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-500-8900
-----------------------------------------------------
Fax | 816-302-9939
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2401 GILLHAM RD ATTN PROVIDER ENROLLMENT DEPT
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64108-4619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-701-5200
-----------------------------------------------------
Fax | 816-302-9939
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080P0205X
-----------------------------------------------------
Taxonomy Name | Pediatric Endocrinology Physician
-----------------------------------------------------
License Number | 0432699
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2080P0205X
-----------------------------------------------------
Taxonomy Name | Pediatric Endocrinology Physician
-----------------------------------------------------
License Number | 2007014000
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------