Jimmie Council Blan, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA1692 Issued in AL

Practice address

100 Memorial Hospital Dr
Suite 3a
Mobile, AL 36608-1183

Phone

(251) 342-2641

Fax

(251) 343-9507

NPI assigned

Sep 17, 2009

Last updated

Jul 27, 2010By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mobile Adult Care LLCGroup PAC ID 4880611326, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Springhill Medical Center Hospital, Mobile, AL, CCN 010144

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Mobile Adult Care LLC

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1588764658
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Springhill Hospitals, Inc

  dba Springhill Memorial Hospital

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1003814971
  Care Compare affiliation

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

{
    "created_epoch": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1093048332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEMORIAL HOSPITAL DR",
            "address_2": "SUITE 3A",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081183",
            "telephone_number": "251-342-2641",
            "fax_number": "251-343-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEMORIAL HOSPITAL DR",
            "address_2": "SUITE 3A",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081183",
            "telephone_number": "251-342-2641",
            "fax_number": "251-343-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAN",
        "first_name": "JIMMIE",
        "middle_name": "COUNCIL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-17",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AL",
            "license": "PA1692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "05110015",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093048332",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Blake
• Georgenna Blakes, CRNP
• Brittney Blakney, RD
• Taylor Blalack, DO
• Temperance Rebekah Blalack, LMFT, MA
• Kristie Blanchard-Burch, M.D.
• Madeleine S Blancher, MD
• Rebecca Blankenhorn, AU.D.
• Blankenship General Surgery, LLC
• Alexander Lee Blankenship, M.D.

• Medical Physician Assistant in Mobile, AL
• Providers in Mobile, AL by specialty
• Medical Physician Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.