Individual provider Active NPI

Peter Cole Blankenhorn, MSN, CRNP

  • Acute Care Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1154842102
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-079655 Issued in AL
Practice address
619 19TH St S
Birmingham, AL 35233-1900
Phone
(205) 934-9999
NPI assigned
Jun 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-079655 AL
Acute Care Nurse Practitioner 363LA2100X 1-079655 AL Primary

Addresses

Primary practice location

619 19TH St S
Birmingham, AL 35233-1900

Mailing address

1406 Ardsley PL
Birmingham, AL 35209-2322
Phone (205) 790-4733

Other practice location 1

500 22nd St S
Birmingham, AL 35233-3110
Phone (205) 996-4450

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pblankenhorn@direct.uabmedicine.org Direct University of Alabama Hospital

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171107000375 AL Practitioner - Nurse Practitioner 0749239218 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-079655ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Oct 1, 2017 Accepting new patients
Emergency Physician Associates, P.a. CurrentSince Jun 1, 2022 Accepting new patients
Medplexmd Injury Past Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

1201 11th Ave S
Birmingham, AL 35205
Phone (205) 930-7100

2000 6th Ave S
Birmingham, AL 35233
Phone (205) 731-9396

500 22nd St S
Birmingham, AL 35233
Phone (205) 801-7440

2010 Medical Center Dr
Homewood, AL 35209
Phone (205) 877-1930

501 Emery Dr W
Hoover, AL 35244
Phone (205) 801-7703

Interoperability endpoints

  • Direct secure messaging: pblankenhorn@direct.uabmedicine.org

Organizations & group practices 4

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1154842102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 ARDSLEY PL",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352092322",
            "telephone_number": "205-790-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-934-9999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 22nd St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352333110",
            "country_code": "US",
            "telephone_number": "205-996-4450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANKENHORN",
        "first_name": "PETER",
        "middle_name": "COLE",
        "credential": "MSN, CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-079655",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-079655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pblankenhorn@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 22nd St S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352333110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.