Provider Demographics
NPI:1316816671
Name:REIGN TELEMED
Entity type:Organization
Organization Name:REIGN TELEMED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCHARD-BAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:513-345-0729
Mailing Address - Street 1:5713 WHITE PINE LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-4588
Mailing Address - Country:US
Mailing Address - Phone:513-332-8206
Mailing Address - Fax:
Practice Address - Street 1:7750 DUDLEY DR STE 4
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45069-2400
Practice Address - Country:US
Practice Address - Phone:513-332-8206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty