Blanco Regional Clinic, P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLANCO REGIONAL CLINIC, P.A.

Practice address

825 4TH St
Blanco, TX 78606-4913

Phone

(830) 833-5581

Fax

(830) 833-4933

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

John D Weaver, MDNPI 1841248408

Title

President

Phone

(830) 833-5581

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Dudley Weaver, MD

  • Family Medicine Physician
  • Johnson City, TX
  • NPI 1841248408
  Medicare reassignment NPD Authorized official
• Thomas F Nohe, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Blanco, TX
  • NPI 1295964591
  Medicare reassignment
• Julie Harding Wisdom, PA-C

  • Physician Assistant
  • San Antonio, TX
  • NPI 1760674022
  Medicare reassignment
• Robert Louis Lee, MD

  • Family Medicine Physician
  • Granbury, TX
  • NPI 1366537482
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1164547519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1629",
            "address_2": "825 FOURTH STREET",
            "city": "BLANCO",
            "state": "TX",
            "postal_code": "786061629",
            "telephone_number": "830-833-5581",
            "fax_number": "830-833-4933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 4TH ST",
            "city": "BLANCO",
            "state": "TX",
            "postal_code": "786064913",
            "telephone_number": "830-833-5581",
            "fax_number": "830-833-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANCO REGIONAL CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-833-5581",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080001301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blanco Community Pharmacy & Health Center LLC
• Blanco County Emergency Services District 2
• Blanco Dentistry and Orthodontics PLLC
• Blanco Physical Therapy
• Blanco Physical Therapy, LLC
• Blanco Volunteer Ambulance Corp. Inc.
• Margaret McQuiston Boswell
• Justin Box, DVM
• Anaiah Christensen, DC
• Nancy Vernon Cline, RDH

• Family Medicine Physician in Blanco, TX
• Providers in Blanco, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.