Individual provider Active NPI

Daron Blankenship, PT, DPT

  • Physical Therapist
  • Dacula, GA
National Provider Identifier
1104474824
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014310 Issued in GA
Practice address
2089 Teron Trce Ste 120
Dacula, GA 30019-1609
Phone
(770) 904-6009
NPI assigned
Aug 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT014310 GA Primary

Addresses

Primary practice location

2089 Teron Trce Ste 120
Dacula, GA 30019-1609

Mailing address

2089 Teron Trce Ste 120
Dacula, GA 30019-1609
Phone (770) 904-6009

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
PT014310GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tender Ones Therapy Services, Inc. Physical Therapist CurrentSince Sep 1, 2019 Accepting new patients

Locations

2089 Teron Trce
Ste 120
Dacula, GA 30019
Phone (770) 904-2357

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1104474824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2089 TERON TRCE STE 120",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191609",
            "telephone_number": "770-904-6009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 TERON TRCE STE 120",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191609",
            "telephone_number": "770-904-6009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "DARON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.