NPIMap

Organization Active NPI

Princess Anne Pediatrics

  • Pediatrics Physician
  • Norfolk, VA
National Provider Identifier
1851559504
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101222303 Issued in VA
Legal business name
PRINCESS ANNE PEDIATRICS
Practice address
5040 E Princess Anne Rd Ste a
Norfolk, VA 23502-1733
Phone
(757) 853-3838
Fax
(757) 853-0940
NPI assigned
May 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Dr. Omar A Blanco, M.D.NPI 1619074531
Title
Sole Proprietor/Pediatrician
Phone
(757) 853-3838

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 0101222303 VA Primary

Addresses

Primary practice location

5040 E Princess Anne Rd Ste a
Norfolk, VA 23502-1733

Mailing address

5040 E Princess Anne Rd Ste a
Norfolk, VA 23502-1733
Phone (757) 853-3838

Other identifiers 5

IdentifierTypeStateIssuer
22917OtherOPTIMA HEALTH
7543052OtherAETNA U.S. HEALTHCARE
6732305OtherVA PREMIER
006732305MedicaidVA
284466OtherANTHEM BLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

5040 E Princess Anne Rd
#A
Norfolk, VA 23502
Phone (757) 853-3838

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1851559504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 E PRINCESS ANNE RD STE A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235021733",
            "telephone_number": "757-853-3838",
            "fax_number": "757-853-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 E PRINCESS ANNE RD STE A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235021733",
            "telephone_number": "757-853-3838",
            "fax_number": "757-853-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCESS ANNE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "BLANCO",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE PROPRIETOR/PEDIATRICIAN",
        "authorized_official_telephone_number": "757-853-3838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101222303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA HEALTH",
            "identifier": "22917",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA U.S. HEALTHCARE",
            "identifier": "7543052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA PREMIER",
            "identifier": "6732305",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006732305",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SHIELD",
            "identifier": "284466",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.