Individual provider Active NPI

Marc Edward Blankenship, RPA

  • Radiology Practitioner Assistant
  • Knoxville, TN
National Provider Identifier
1043546336
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Practitioner AssistantTaxonomy code 243U00000X
License
RA 0000000010 Issued in TN
Practice address
5401 Kingston Pike Ste 540
Knoxville, TN 37919-5054
Phone
(865) 584-7376
NPI assigned
Oct 22, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Practitioner Assistant 243U00000X RA 0000000010 TN Primary

Addresses

Primary practice location

5401 Kingston Pike Ste 540
Knoxville, TN 37919-5054

Mailing address

5401 Kingston Pike Ste 540
Knoxville, TN 37919-5054
Phone (865) 584-7376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RA 0000000010TNMDRadiology Practitioner Assistant

NPI Registry JSON

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1043546336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 KINGSTON PIKE STE 540",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195054",
            "telephone_number": "865-584-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 KINGSTON PIKE STE 540",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195054",
            "telephone_number": "865-584-7376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "MARC",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "RPA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-22",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "243U00000X",
            "taxonomy_group": "",
            "desc": "Radiology Practitioner Assistant",
            "state": "TN",
            "license": "RA 0000000010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; 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.