Individual provider Active NPI

Juan Santiago Blanch, MD

  • Internal Medicine Physician
  • Morgan City, LA
National Provider Identifier
1124068127
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
07362R Issued in LA
Practice address
1125 Marguerite St
Morgan City, LA 70380-1855
Phone
(504) 866-1336
NPI assigned
Jun 7, 2006
Last updated
Apr 11, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 07362R LA
Internal Medicine Physician 207R00000X 07362R LA Primary

Addresses

Primary practice location

1125 Marguerite St
Morgan City, LA 70380-1855

Mailing address

200 Corporate Blvd
Suite 201
Lafayette, LA 70508-3870
Phone (504) 866-1336

Other identifiers 1

IdentifierTypeStateIssuer
1371254MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
07362RLAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sulphur Emergency Group LLC Emergency Medicine Past Accepting new patients
C & M Medical Services, Inc. Past Accepting new patients
Metairie Physician Services Inc. Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: juan.blanch@316232690761732.direct.elationemr.com
  • Direct secure messaging: juan.blanch@direct.ejgh.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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1124068127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "504-866-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MARGUERITE ST",
            "city": "MORGAN CITY",
            "state": "LA",
            "postal_code": "703801855",
            "telephone_number": "504-866-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCH",
        "first_name": "JUAN",
        "middle_name": "SANTIAGO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "07362R",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "07362R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1371254",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgan City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.