Jill Gwaltney Blankenberg, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5410 Issued in NC

Practice address

5350 Vinning St
Concord, NC 28027-2936

Phone

(704) 783-2580

NPI assigned

Feb 29, 2008

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

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Paragon Outpatient Rehabilitation Services, LLC

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1871867325

  NC

  Medicare reassignment Care Compare group NPD
• Paragon Outpatient Rehabilitation Services, LLC

  • Rehabilitation Clinic/Center
  • Roxboro, NC
  • NPI 1245014380
  NPD

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1083884415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5350 VINNING ST",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280272936",
            "telephone_number": "704-783-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5350 VINNING ST",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280272936",
            "telephone_number": "704-783-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENBERG",
        "first_name": "JILL",
        "middle_name": "GWALTNEY",
        "name_prefix": "Ms.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "5410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cadricia Blair
• Rebecca R Blair, RN
• Valerie Blair, FNP-C
• Nathan Allen Blake, CRNA
• Heaven Blakely
• Chad Elvis Blankenship, PA-C
• Emily Collins Blankenship, NP
• Meghann Jones Blankenship, MD
• Bobbi Jo Schneider Blanton
• Julia Lynn Blevins Richards, MD

• Speech-Language Pathologist in Concord, NC
• Providers in Concord, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.