Individual provider Active NPI

Stephanie A Blanco, CNM

  • Advanced Practice Midwife
  • Henrico, VA
National Provider Identifier
1962805747
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
0024171391 Issued in VA
Practice address
1602 Skipwith Rd
Henrico, VA 23229-5205
Phone
(804) 289-4530
NPI assigned
Oct 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 0024171391 VA Primary

Addresses

Primary practice location

1602 Skipwith Rd
Henrico, VA 23229-5205

Mailing address

4204 Brook Rd
Richmond, VA 23227-3702
Phone (517) 937-5340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151109002557 VA Practitioner - Certified Nurse Midwife (CNM) 4587974282 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
0024171391VAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Aug 20, 2023 Accepting new patients
Privia Medical Group, LLC CurrentSince Aug 20, 2023 Accepting new patients
Obhg Virginia, LLC CurrentSince Dec 18, 2018 Accepting new patients

Locations

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736

8644 Sudley Rd
#220
Manassas, VA 20110

13710 St Francis Blvd
Midlothian, VA 23114
Phone (804) 594-7300

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1962805747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 BROOK RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232273702",
            "telephone_number": "517-937-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 SKIPWITH RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232295205",
            "telephone_number": "804-289-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-07",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VA",
            "license": "0024171391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

Verify at the official NPI Registry.