Leonard Gregory Blanton, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Bossier City, LA
NPI 1831135698 · NPPES record last updated Jun 18, 2021
Key facts
- NPI
- 1831135698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 021950 (LA)
- Practice address
- 2449 Hospital Dr
Suite 260
Bossier City, LA 71111-2399 - Phone
- (318) 212-7840
- Fax
- (318) 212-7845
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Louisiana State University School of Medicine in Shreveport, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- WK Bossier OB-GYN
Practice addresses (Care Compare)
2449 Hospital Dr
Suite 260
Bossier City, LA 71111-2399
Phone (318) 212-7840
Hospital & facility affiliations
- Willis Knighton Medical Center
- Christus Shreveport-Bossier Health System
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040817000471 | LA | Practitioner - Obstetrics/Gynecology | 2961475025 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021950 | LA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| L Gregory Blanton MD and Willis Knighton Medical Ctr | Obstetrics & Gynecology | Current | Accepting new patients |
| WK Bossier OB-GYN | Obstetrics & Gynecology | Current |
Accepting new patients |
| Willis Knighton Medical Center, Inc. | Past | Accepting new patients |
Locations
2449 Hospital Dr
Ste 260
Bossier City, LA 71111
Phone (318) 212-7840
2300 Hospital Dr
Ste 360
Bossier City, LA 71111
Phone (318) 212-7840
2300 Hospital Dr
Ste 420
Bossier City, LA 71111
Phone (318) 212-7840
Interoperability endpoints
- lblanton@direct.wkhs.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 021950 | LA | Yes |
Addresses
Primary practice location
2449 Hospital Dr
Suite 260
Bossier City, LA 71111-2399
Mailing address
2449 Hospital Dr
Suite 260
Bossier City, LA 71111-2399
Phone (318) 212-7840
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538515 | Medicaid | LA | |
| 060901802 | Medicaid | TX |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://www.mettles.com/ | Other |
Other providers in Bossier City, LA
- Miranda Rashay Blackmon
- Mackenzie R Blackwell
- Shemary Blake
- Kaitlyn Bland Rogers
- Barbara Lynn Bland
- Kristopher Brent Blaylock
- Jaime Blazier
- Marjorie Blochousse
- Earl Bloomer
- Alice C Blue
All providers in Bossier City, LA · Obstetrics & Gynecology Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.