Edward A. Blanco, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

290033 Issued in KY

Practice address

12464 La Grange Rd
Louisville, KY 40245-1901

Phone

(502) 205-2090

Fax

(502) 205-2091

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, KY2 enrollments

Enrollment records 2

Specialty

Chiropractic

Education

Life Chiropractic College, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• OH PPO
• TN PPO C-SNP
• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
• TN PPO
• KY PPO C-SNP
• KY PPO

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24476/brand/15/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Core Health Centers of Forest Springs, LLC

  • Chiropractor
  • Louisville, KY
  • NPI 1396518882
  Medicare reassignment NPD
• Optimal Health PLLC

  • General Practice Physician
  • Knoxville, TN
  • NPI 1477812196

  Chiropractor

  Medicare reassignment NPD
• Optimal Medical PLLC

  • General Practice Physician
  • Knoxville, TN
  • NPI 1689354284
  Medicare reassignment NPD
• Optimal Health PLLC

  • Nurse Practitioner
  • Knoxville, TN
  • NPI 1952838708
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1013003771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12464 LA GRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402451901",
            "telephone_number": "502-205-2090",
            "fax_number": "502-205-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12464 LA GRANGE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402451901",
            "telephone_number": "502-205-2090",
            "fax_number": "502-205-2091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 B Sherway Rd",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "37922",
            "country_code": "US",
            "telephone_number": "865-670-0650",
            "fax_number": "865-531-0480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "EDWARD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000001562",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "290033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3970873",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Paul Blanchard, DMD
• Valerie Yankowy Blanchette
• Yudel Blanco Alejo, APRN
• Merilda Onyfel Blanco-Guzman, MD
• Ashley Blanco
• Mya Marie Blanco, DMD
• Andrea Bland
• Ashley Bland, PHARMD
• Felecia Bland
• Hannah Bland

• Chiropractor in Louisville, KY
• Providers in Louisville, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.