Moline Jephtee Blanc

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9108843 Issued in FL

Practice address

1133 Saxon Blvd Ste 200
Orange City, FL 32763-8425

Phone

(386) 228-9700

NPI assigned

Sep 23, 2015

Last updated

Apr 7, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Physician Assistant

Education

University of Toledo College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Guided Health Florida LLC

  • Family Medicine Physician
  • West Palm Beach, FL
  • NPI 1144181603

  Physician Assistant

  Medicare reassignment NPD Authorized official
• Shekinah Health & Wellness Center, LLC

  • Family Medicine Physician
  • Ormond Beach, FL
  • NPI 1346719812
  Medicare reassignment Authorized official
• New Smyrna Beach Urgent Care, LLC

  • Basic Emergency Medical Technician
  • New Smyrna Beach, FL
  • NPI 1801126297
  Medicare reassignment

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1215306998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 DUNN AVE APT 314",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141475",
            "telephone_number": "561-317-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 SAXON BLVD STE 200",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638425",
            "telephone_number": "386-228-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANC",
        "first_name": "MOLINE",
        "middle_name": "JEPHTEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9108843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Betzner
• Janak Hirabhai Bhavsar, MD
• Gertrude C Birkhahn
• Lela A Bizzaro, MA
• Blair Group Home
• Richard Carroll Bledsoe, PT
• Russell Gordon Blenis, PHARM.D.
• Penelope Block, M.D.
• Becky Blondell
• Kris M Bly, DO

• Physician Assistant in Orange City, FL
• Providers in Orange City, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; 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.