Stawa Rajab Blanco

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0026867 Issued in OH

Practice address

6121 Colerain Ave
Cincinnati, OH 45239-6417

Phone

(513) 354-2466

Fax

(513) 906-5477

NPI assigned

Aug 26, 2020

Last updated

Dec 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dedicated Ohio Holding LLCGroup PAC ID 2769718659, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Dedicated Ohio Holding LLC

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1922631019

  OH

  Medicare reassignment Care Compare group NPD
• CG Medical Associates Inc

  • Urgent Care Clinic/Center
  • Cincinnati, OH
  • NPI 1982903951
  Medicare reassignment
• Dedicated Ohio Holding, LLC

  dba Dedicated Senior Medical Center Mt. Airy

  • Non-Pharmacy Dispensing Site
  • Cincinnati, OH
  • NPI 1407475643
  NPD

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1073126314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 COLERAIN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452396417",
            "telephone_number": "513-354-2466",
            "fax_number": "513-906-5477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 COLERAIN AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452396417",
            "telephone_number": "513-354-2466",
            "fax_number": "513-906-5477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "STAWA",
        "middle_name": "RAJAB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-26",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "30144773",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "110700",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "0026867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cierra Blakeman
• Aniysha Sonji Blanchard
• Jennifer Marie Blanchard, PHARM.D., BCPS
• Nia Blanchard, MD
• Trevor William Gordon Blanchard, M.D.
• Adrienne Marie Bland, LSW
• Alexa Zuber Blandford, RDN, LD
• Candace Michele Blank, LSW
• Fernando Blank, MD
• Rachel C Blank

• Family Nurse Practitioner in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.