Carol A Blank, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

MD069190L Issued in PA

Practice address

11 Hunters TRL
Gettysburg, PA 17325-7281

Phone

(717) 334-7681

Fax

(717) 334-0730

NPI assigned

Aug 17, 2005

Sex

Female

Sole proprietor

No

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

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Gettysburg Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Gettysburg, PA
  • NPI 1740272640

  Adolescent Medicine

  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1043202047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HUNTERS TRL",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173257281",
            "telephone_number": "717-334-7681",
            "fax_number": "717-334-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HUNTERS TRL",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173257281",
            "telephone_number": "717-334-7681",
            "fax_number": "717-334-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "CAROL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PA",
            "license": "MD069190L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017562320001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzette Berlin
• Biggins & Co. Counseling
• Courtney Billow
• Jennifer A. Bishop, C.R.N.P.
• Angela D Blain, CRNP
• Bonneauville Community Fire Company, Inc
• Jessica Bonnett
• Angela Louise Borger, CRNP
• Toby Allen Bortner, PT
• Katherine C Boyle, CRNP

• All providers in Gettysburg, PA
• Pediatric Adolescent Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.