=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871488049
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAPIENTIA HEALTH PUBLIC TRUST
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/10/2025
-----------------------------------------------------
Last Update Date | 06/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8400 W 110TH ST STE 270
-----------------------------------------------------
City | OVERLAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66210-2468
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-390-7173
-----------------------------------------------------
Fax | 850-390-7174
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9100 S DADELAND BLVD STE 1500
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33156-7816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-390-7173
-----------------------------------------------------
Fax | 850-390-7174
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TRUSTEE
-----------------------------------------------------
Name | PATRICK ALLAN BLANCHARD
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 850-390-7173
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207QH0002X
-----------------------------------------------------
Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------