Active NPI
D. Michael Blankenship, MD
- Specialist
- Texarkana, AR
National Provider Identifier
1093833188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- D. MICHAEL BLANKENSHIP, MD
- Practice address
- 422 Beech St
Texarkana, AR 71854-5310 - Phone
- (870) 773-1111
- Fax
- (870) 772-7692
- NPI assigned
- Mar 27, 2007
- Last updated
- Jun 20, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Dennis Michael Blankenship, MD
- Title
- President
- Phone
- (870) 773-1111
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
422 Beech St
Texarkana, AR 71854-5310
Mailing address
422 Beech St
Texarkana, AR 71854-5310
Phone (870) 773-1111
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 156782801 | Medicaid | TX | |
| 8F4570 | Other | TX | TX BLUE CROSS |
| 88HD | Other | TX | TX BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Nephrology Physician
- Texarkana, AR
- NPI 1821086547
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213920000000",
"number": "1093833188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "422 BEECH ST",
"city": "TEXARKANA",
"state": "AR",
"postal_code": "718545310",
"telephone_number": "870-773-1111",
"fax_number": "870-772-7692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "422 BEECH ST",
"city": "TEXARKANA",
"state": "AR",
"postal_code": "718545310",
"telephone_number": "870-773-1111",
"fax_number": "870-772-7692"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "D. MICHAEL BLANKENSHIP, MD",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-27",
"last_updated": "2008-06-20",
"status": "A",
"authorized_official_last_name": "BLANKENSHIP",
"authorized_official_first_name": "DENNIS",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "870-773-1111",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "156782801",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX BLUE CROSS",
"identifier": "8F4570",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX BLUE CROSS",
"identifier": "88HD",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.