Individual provider Active NPI

Elizabeth Kaylor Blanton

  • Family Medicine Physician
  • Angola, IN
National Provider Identifier
1740867498
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02007711A Issued in IN
Practice address
1500 W Maumee St
Angola, IN 46703-8605
Phone
(606) 658-4942
Fax
(260) 668-5690
NPI assigned
Mar 27, 2021
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02007711A IN Primary

Addresses

Primary practice location

1500 W Maumee St
Angola, IN 46703-8605

Mailing address

416 E Maumee St
Angola, IN 46703-2015
Phone (260) 667-5131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240830003403 IN Practitioner - Family Practice 3375942014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Marian University College of Osteopathic Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cameron Memorial Community Hospital IncGroup PAC ID 9234020835, shared by 8 NPIs, 83 clinicians

Practice addresses (Care Compare)

1500 W Maumee St
Angola, IN 46703-8605
Phone (260) 667-5670

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Cameron Memorial Community Hospital, Inc. CurrentSince Aug 22, 2024 Accepting new patients
Cameron Memorial Community Hospital, Inc Family Medicine CurrentSince Aug 22, 2024 Accepting new patients
Cameron Memorial Community Hospital Inc Past Accepting new patients

Locations

1500 W Maumee St
Angola, IN 46703
Phone (260) 665-8494

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

Organizations & group practices 3

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 1

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": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1740867498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467032015",
            "telephone_number": "260-667-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W MAUMEE ST",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467038605",
            "telephone_number": "606-658-4942",
            "fax_number": "260-668-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANTON",
        "first_name": "ELIZABETH",
        "middle_name": "KAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-27",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02007711A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

Verify at the official NPI Registry.