NPIMap

Organization Active NPI

Blankenship Medical Group PLLC

  • Family Medicine Physician
  • MC Minnville, TN
National Provider Identifier
1104849116
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD17499 Issued in TN
Legal business name
BLANKENSHIP MEDICAL GROUP PLLC
Practice address
306 N Chancery St
MC Minnville, TN 37110-8904
Phone
(931) 507-4500
Fax
(931) 507-4502
NPI assigned
Jul 25, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Brad E Blankenship, MD
Title
Owner
Phone
(615) 796-0902

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MD17499 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

306 N Chancery St
MC Minnville, TN 37110-8904

Mailing address

PO Box 330699
Murfreesboro, TN 37133-0699
Phone (931) 507-4500

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
3735031MedicaidTN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 8, 2008.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1104849116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 330699",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371330699",
            "telephone_number": "931-507-4500",
            "fax_number": "931-507-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N CHANCERY ST",
            "city": "MC MINNVILLE",
            "state": "TN",
            "postal_code": "371108904",
            "telephone_number": "931-507-4500",
            "fax_number": "931-507-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANKENSHIP MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-796-0902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD17499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3735031",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Minnville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; 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.