Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Blake Jon Lundgren, DPT

Individual provider Physical Therapist · NPI 1578109153

Dr. Blake Jon Lundgren, DPT is a Physical Therapist in Private Practice in Aiken, South Carolina. Qualified in 2019, 7 years ago. Practices with Coastal Rehabilitation Inc, a 17-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Maine and North Carolina.

Years since qualifying
7
Licensed in
ME, NC
In the registry since
2019
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

1397 Silver Bluff Rd Ste 100
Aiken, SC 29803-9784
Phone: (803) 220-1073
Fax: (803) 380-7044
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 24 Hospital Ln, Calais, ME 04619-1329 — (207) 454-2544
  • 115 Loftin Ln, Ahoskie, NC 27910-3449 — (252) 209-0901

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence CP022892T (NC)
Physical Therapist Taxonomy 225100000X · Licence 5520 (ME)

Record details

NPI number1578109153
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedNovember 19, 2019
Last updated in NPPESJuly 23, 2025
Certification dateJuly 23, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Coastal Rehabilitation Inc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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