NPIMap

Individual provider Active NPI

Devon Blandford, PA-C

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1023763869
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TC267 Issued in KY
Practice address
200 E Chestnut St BLDG Ste 303
Louisville, KY 40202-1831
Phone
(502) 629-5552
NPI assigned
Feb 21, 2022
Last updated
Apr 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X TC267 KY Primary

Addresses

Primary practice location

200 E Chestnut St BLDG Ste 303
Louisville, KY 40202-1831

Mailing address

3206 Five Oaks PL
Louisville, KY 40207-4306
Phone (502) 550-8654

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dblandford125953@direct.nortonhealthcare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221228000521 KY Practitioner - Physician Assistant 8123498656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1270

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

850 S 28TH St
Louisville, KY 40211-1223

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TC267KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Community Medical Associates, Inc. CurrentSince Nov 1, 2022 Accepting new patients

Locations

200 E Chestnut St
Ste 303
Louisville, KY 40202
Phone (502) 629-5552

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: dblandford125953@direct.nortonhealthcare.org

Organizations & group practices 3

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

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1023763869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 FIVE OAKS PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074306",
            "telephone_number": "502-550-8654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CHESTNUT ST BLDG STE 303",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021831",
            "telephone_number": "502-629-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANDFORD",
        "first_name": "DEVON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dblandford125953@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "200 E Chestnut St Bldg Ste 303",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.