Individual provider Active NPI

Lauren Boyd Blanchard, CNFP

  • Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1326057092
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21484 Issued in CA
Practice address
3100 Telegraph Ave
Suite 2102
Oakland, CA 94609-3239
Phone
(510) 286-8175
Fax
(510) 286-8158
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R48284 NM
Nurse Practitioner 363L00000X 21484 CA Primary

Addresses

Primary practice location

3100 Telegraph Ave
Suite 2102
Oakland, CA 94609-3239

Mailing address

3100 Telegraph Ave
Suite 2102
Oakland, CA 94609-3239
Phone (510) 286-8175

Other identifiers 1

IdentifierTypeStateIssuer
28958519MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20141107000009 CA Practitioner - Nurse Practitioner 8022057603 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
21484CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
East Bay Center for Digestive Health Medical Associates, Inc CurrentSince Oct 12, 2020 Accepting new patients

Locations

300 Ogawa Plz
Ste 450
Oakland, CA 94612
Phone (510) 433-7821

Interoperability endpoints

  • Direct secure messaging: lblanchard33689@smch.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/15506/brand/4/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1326057092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 TELEGRAPH AVE",
            "address_2": "SUITE 2102",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093239",
            "telephone_number": "510-286-8175",
            "fax_number": "510-286-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 TELEGRAPH AVE",
            "address_2": "SUITE 2102",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093239",
            "telephone_number": "510-286-8175",
            "fax_number": "510-286-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "LAUREN",
        "middle_name": "BOYD",
        "credential": "CNFP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R48284",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "21484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28958519",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.