Patricia V Blanc, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

004186 Issued in CT

Practice address

727 Honeyspot Rd
Stratford, CT 06615-7172

Phone

(203) 375-7242

Fax

(203) 375-2318

NPI assigned

Sep 2, 2009

Last updated

Apr 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, CT
  • NPI 1669445946
  Medicare reassignment NPD
• Stella Medical Care LLC

  • Adult Health Nurse Practitioner
  • Stamford, CT
  • NPI 1255851481
  Medicare reassignment NPD
• Optimus Health Care Inc

  dba Stratford Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Stratford, CT
  • NPI 1922378496
  NPD (past)

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1982837233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "982 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066081913",
            "telephone_number": "203-696-3260",
            "fax_number": "203-375-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 HONEYSPOT RD",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066157172",
            "telephone_number": "203-375-7242",
            "fax_number": "203-375-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANC",
        "first_name": "PATRICIA",
        "middle_name": "V",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-02",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "004186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE",
            "identifier": "4186",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Big Y Foods, Inc. (Big Y Pharmacy #84)
• Carey Jaimie Biondi, RD, CD-N
• BJ's Wholesale Club Inc.
• Black Quin LLC
• Marina Blagodatny, MD
• Sarah Blasius
• Bloom Psych Services LLC
• George Bloom
• Gabrielle Lucille Bodin
• Body Intelligence Holistic Health Center, LLC

• Nurse Practitioner in Stratford, CT
• Providers in Stratford, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.