LORETTA BLANCHARD (NP) – Nurse Practitioner, NPI 1104103613
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for LORETTA BLANCHARD (NP)
707 PLATINUM PT
LAKE MARY, FL 327465702
Phone: (407) 878-0910
Type: Mailing
945 BETHESDA DR
SUITE 200
ZANESVILLE, OH 437010801
Phone: (740) 450-6175
Fax: (740) 450-6157
Type: Mailing
800 FOREST AVE
RM 4030
ZANESVILLE, OH 437012882
Phone: (740) 454-5398
Type: Location
5821 S WILLIAMSON BLVD STE 204
PORT ORANGE, FL 321286102
Phone: (386) 231-6300
Fax: (386) 322-6165
Type: Mailing
5821 S WILLIAMSON BLVD
STE 204
PORT ORANGE, FL 32128
Phone: (386) 231-6300
Fax: (386) 322-6165
Type: Location
PO BOX 9671
DAYTONA BEACH, FL 321209671
Phone: (407) 878-0910
Fax: (407) 878-0911
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $259.
Total Amount is formed as General ($259) + Research ($0) + Ownership ($0) = $259.
Last reported payment date: 2024-10-24 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($125).
Total Amount
$259
General + Research + Ownership
Payments
8
Total payment records
General Amount
$259
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-24
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2021-11-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20211124001535 | I | Nurse Practitioner | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32746)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | OH | 90670 | Pneumococcal vaccine for injection into muscle | 40 | 40 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | OH | |
| - | OH | |
| - | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Nurse Practitioner | OH | |
| Physician Assistant | OH | |
| Nurse Practitioner | OH |
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