{"npi":"1710104484","type":"NPI-1","status":"active","name":{"display":"Dr. Gustav Blomquist MD","other":[],"first":"GUSTAV","last":"BLOMQUIST","middle":"A","credential":"MD"},"specialty":{"primary_taxonomy":"2085R0202X","primary_taxonomy_description":"Diagnostic Radiology","slug":"diagnostic-radiology","schema_org_specialty":"Radiography","all":[{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"TX","license":"M6052"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"AL","license":"29216"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"FL","license":"ME107556"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"GA","license":"63634"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"MS","license":"20968"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"NC","license":"2010-00231"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"SC","license":"32233.MD"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"TN","license":"MD0000045451"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"KY","license":"43773"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":false,"state":"OH","license":"35.152015"},{"code":"2085R0202X","description":"Diagnostic Radiology","primary":true,"state":"WV","license":"3441"}]},"addresses":[{"purpose":"LOCATION","street_1":"3448 US ROUTE 60","city":"HUNTINGTON","state":"WV","postal_code":"257052906","country_code":"US","phone":"3045221550","fax":"3045221073"},{"purpose":"MAILING","street_1":"3448 US ROUTE 60","city":"HUNTINGTON","state":"WV","postal_code":"257052906","country_code":"US","phone":"3045221550","fax":"3045221073"}],"license":{"state":"WV","number":"3441"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"7100126970","state":"KY","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20100915001091","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"KY","pac_id":"8820140973"},{"enrlmt_id":"I20160511001572","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"TN","pac_id":"8820140973"},{"enrlmt_id":"I20231102001046","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"WI","pac_id":"8820140973"},{"enrlmt_id":"I20241126004133","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"OH","pac_id":"8820140973"},{"enrlmt_id":"I20241218001466","type_code":"14-30","type_desc":"PRACTITIONER - DIAGNOSTIC RADIOLOGY","state":"WV","pac_id":"8820140973"}]},"enumeration_date":"2007-04-20","last_updated":"2024-10-25","_meta":{"source":"NPPES","snapshot_date":"2024-10-25","doc_url":"https://findmynpi.com/api"}}