Larry Theodore Blanz, ED.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

P 1037 Issued in TN

Practice address

1900 Church St 300
Nashville, TN 37203-2285

Phone

(615) 337-2026

Fax

(815) 301-9511

NPI assigned

Jan 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438992000000",
    "number": "1073591194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 CHIMNEY HL",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372212219",
            "telephone_number": "615-337-2026",
            "fax_number": "815-301-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 CHURCH ST 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032285",
            "telephone_number": "615-337-2026",
            "fax_number": "815-301-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANZ",
        "first_name": "LARRY",
        "middle_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2015-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "P 1037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3684193",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maya Blanks
• Stephen Blanks, CRNA
• Joseph Morgan Blankush, M.D.
• Stephanie Blansett, RN
• Molly Hassett Blanton, NP
• Poppy Montana-Marie Blaseio, D.D.S.
• Anthony Blash, PHARM.D.
• Sara Foster Blass, PT, DPT, NCS
• Jill Blattner, M.S.
• Peartare Blayde, RN

• Psychologist in Nashville, TN
• Providers in Nashville, TN by specialty
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.