Individual provider Active NPI

Thomas Blanks, M.D.

  • Internal Medicine Physician
  • Gulfport, MS
National Provider Identifier
1063452639
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
08702 Issued in MS
Practice address
1110 Broad Ave
Suite 700
Gulfport, MS 39501-8907
Phone
(228) 864-0314
Fax
(228) 864-0425
NPI assigned
Jun 8, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 08702 MS Primary

Addresses

Primary practice location

1110 Broad Ave
Suite 700
Gulfport, MS 39501-8907

Mailing address

PO Box 1810
Gulfport, MS 39502-1810
Phone (228) 865-1453

Other names 1

  • Dr. Thomas Blanks Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080905000365 MS Practitioner - Internal Medicine 1850467481 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Mississippi School of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Gulfport, MS 39501-2460

4533 13TH St
Gulfport, MS 39501-2516
Phone (228) 214-9640

4577 13TH St
Gulfport, MS 39501-2516
Phone (228) 864-2752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
08702MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Jul 1, 2008 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Jul 1, 2008 Accepting new patients

Locations

1756 Popps Ferry Rd
Ste A
Biloxi, MS 39532
Phone (228) 865-3200

1110 Broad Ave
Ste 700
Gulfport, MS 39501
Phone (228) 864-0314

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4855

1612 31st Ave
Gulfport, MS 39501
Phone (228) 865-1453

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

4500 13th St
#P
Gulfport, MS 39501
Phone (228) 865-3451

5120 Beatline Rd
#A
Long Beach, MS 39560
Phone (228) 868-4287

Interoperability endpoints

  • Direct secure messaging: tblanks@direct.mhg.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1063452639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021810",
            "telephone_number": "228-865-1453",
            "fax_number": "228-865-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 BROAD AVE",
            "address_2": "SUITE 700",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395018907",
            "telephone_number": "228-864-0314",
            "fax_number": "228-864-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKS",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "08702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "BLANKS",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.