Individual provider Active NPI

Meagan Teal Blanchard, M.D.

  • Pediatrics Physician
  • Baton Rouge, LA
National Provider Identifier
1891094603
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2160290 Issued in LA
Practice address
8415 Goodwood Blvd
Suite 104
Baton Rouge, LA 70806-7851
Phone
(225) 925-9797
Fax
(225) 925-9787
NPI assigned
Mar 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2160290 LA Primary

Addresses

Primary practice location

8415 Goodwood Blvd
Suite 104
Baton Rouge, LA 70806-7851

Mailing address

8415 Goodwood Blvd
Suite 104
Baton Rouge, LA 70806-7851
Phone (225) 925-9797

Other identifiers 1

IdentifierTypeStateIssuer
2160290MedicaidLA

Other names 1

  • Meagan Celeste Teal Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mblanchard5592@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epihosted.com/FHIRPoxy/api/FHIR/DSTU2/ Other

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141113001796 LA Practitioner - Pediatric Medicine 7618199340 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2160290LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Pediatrics CurrentSince Oct 13, 2014 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Oct 13, 2014 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients
Woman's Hospital Foundation Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

8415 Goodwood Blvd
Ste 104
Baton Rouge, LA 70806
Phone (225) 925-9797

Interoperability endpoints

  • Direct secure messaging: mblanchard5592@direct.casso.us.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1891094603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 GOODWOOD BLVD",
            "address_2": "SUITE 104",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067851",
            "telephone_number": "225-925-9797",
            "fax_number": "225-925-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 GOODWOOD BLVD",
            "address_2": "SUITE 104",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067851",
            "telephone_number": "225-925-9797",
            "fax_number": "225-925-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "MEAGAN",
        "middle_name": "TEAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-18",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "2160290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2160290",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mblanchard5592@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mblanchard5592@direct.casso.us.com",
            "address_1": "8415 Goodwood Blvd",
            "address_2": "Suite 104",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708067851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epihosted.com/FHIRPoxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8415 Goodwood Blvd",
            "address_2": "Suite 104",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708067851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MEAGAN",
            "last_name": "TEAL",
            "middle_name": "CELESTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.