Staci Blankenship, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2003011549 Issued in MO

Practice address

4358 Hwy PP
Poplar Bluff, MO 63901-1530

Phone

(573) 686-5439

Fax

(573) 778-0103

NPI assigned

Apr 13, 2006

Last updated

Sep 16, 2010By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bizzee Kidz Therapy, LLC

  • Physical Therapist
  • Poplar Bluff, MO
  • NPI 1659686038

  Occupational Therapist

  NPD (past) Authorized official
• Ozark Physical Therapy, LLP

  • Durable Medical Equipment & Medical Supplies
  • Poplar Bluff, MO
  • NPI 1942272836
  NPD (past)

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1003870304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1296",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639021296",
            "telephone_number": "573-686-5439",
            "fax_number": "573-778-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4358 HWY PP",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011530",
            "telephone_number": "573-686-5439",
            "fax_number": "573-778-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "STACI",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2003011549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "475775235",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George Frederick Blaich V, D.D.S.
• John R Blaich, D.M.D.
• Lauren E Blaich, D.D.S.
• Travis D Blaich, D.D.S.
• Elizabeth Marrie Bland
• Timothy Blankenship, O.D.
• Linda Kay Blasingame, APRN
• Bluff Area Therapy Center, LLC
• Bluff Home Care LLC
• Bluff Prosthetics and Orthotics LLC (SEMO Prosthetics & Orthotics)

• Occupational Therapist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.