Physician Compare National (NPI:1750339214)

HEALTHCARE PROVIDER: KRISTINA B. BLOHM M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1750339214
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6305871476
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050928000736
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RUDGEAR
	Individual professional last name
Provider First Name	KRISTINA
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	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.

Medical School Information
Medical School Name	UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	EDLC, LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	8820332836
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	7344 E DEER VALLEY RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	SCOTTSDALE
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	852557456
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4805131042150
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	030014
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HONORHEALTH JOHN C LINCOLN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y