Individual provider Active NPI

Jean Claude Blanchard, NP

  • Nurse Practitioner
  • Thibodaux, LA
National Provider Identifier
1588005003
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP07462 Issued in LA
Practice address
1320 Martin Luther King Dr
Thibodaux, LA 70301-4886
Phone
(985) 446-2021
Fax
(985) 447-1546
NPI assigned
Jul 12, 2013
Last updated
Oct 8, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP07462 LA Primary

Addresses

Primary practice location

1320 Martin Luther King Dr
Thibodaux, LA 70301-4886

Mailing address

PO Box 4176
Houma, LA 70361-4176
Phone (985) 876-0300

Other identifiers 1

IdentifierTypeStateIssuer
2348078MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20131114000377 LA Practitioner - Nurse Practitioner 0648406017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Institute of the South, LLCGroup PAC ID 3779497441, 145 clinicians

Practice addresses (Care Compare)

1320 Martin Luther King Dr
Thibodaux, LA 70301-4886
Phone (985) 446-2021

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP07462LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Regional Network Development Corporation PastSince Mar 18, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jblanchard235011@direct.ochsner.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1588005003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4176",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703614176",
            "telephone_number": "985-876-0300",
            "fax_number": "985-872-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MARTIN LUTHER KING DR",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014886",
            "telephone_number": "985-446-2021",
            "fax_number": "985-447-1546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "JEAN",
        "middle_name": "CLAUDE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-12",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP07462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2348078",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.