John Paul Blanchard, ACNP-BC
Individual provider Active NPI Acute Care Nurse Practitioner · Modesto, CA
NPI 1851875397 · NPPES record last updated Sep 20, 2018
Key facts
- NPI
- 1851875397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 95010076 (CA)
- Practice address
- 1700 Coffee Rd
Modesto, CA 95355-2803 - Phone
- (209) 526-4500
- NPI assigned
- Sep 20, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211001003001 | ID | Order and Referring Only - Nurse Practitioner | 1759789910 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95010076 | CA | MD | Acute Care Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 95010076 | CA | Yes |
Addresses
Primary practice location
1700 Coffee Rd
Modesto, CA 95355-2803
Mailing address
3702 Sylvan CT
Rocklin, CA 95765-4618
Phone (406) 531-6697
Other practice location 1
1401 Spanos Ct Ste 108
Modesto, CA 95355-2812
Phone (209) 525-3848
Other providers in Modesto, CA
- Blake D. Alexander, MD PC
- Kiley Blake
- Matthew Presnell Blakeley
- Vida Lorraine Blakely
- Fanny Blancas
- Alicia Blanco
- Bianca Priscilla Blanco
- Francesca Raquel Blanco
- Hilda Blanco
- Stephanie Bland
All providers in Modesto, CA · Acute Care Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2018. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.