Active NPI
Ann Blancke
- Pharmacist
- Guerneville, CA
National Provider Identifier
1285024166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 43852
- Practice address
- 16251 Main St
Guerneville, CA 95446-8300 - Phone
- (707) 869-9055
- Fax
- (707) 869-9201
- NPI assigned
- Jan 29, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 43852 | CA | Primary |
Addresses
Primary practice location
16251 Main St
Guerneville, CA 95446-8300
Mailing address
2325 Avenida de Las Brisas
Santa Rosa, CA 95405-8602
Phone (707) 541-7302
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43852 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sebastopol Family Pharmacy, Inc. | Past | Accepting new patients | |
| Lark Rexall Drugs Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Guerneville, CA
- NPI 1750484820
-
- Community/Retail Pharmacy
- Sebastopol, CA
- NPI 1457858565
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422489600000",
"number": "1285024166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2325 AVENIDA DE LAS BRISAS",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954058602",
"telephone_number": "707-541-7302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16251 MAIN ST",
"city": "GUERNEVILLE",
"state": "CA",
"postal_code": "954468300",
"telephone_number": "707-869-9055",
"fax_number": "707-869-9201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANCKE",
"first_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-29",
"last_updated": "2015-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "43852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Guerneville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.