Branden Blanton, AGNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP140112 Issued in TX

Practice address

708 Bentley CT
Tyler, TX 75703-4621

Phone

(903) 780-1186

NPI assigned

Mar 25, 2019

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

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IFFBCD
• FHIR API: https://api.platform.athenahealth.com/13771/brand/1/csg/1/fhir/r4

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.

• Corinthia McLeroy, MD PA

  dba Encompass Medical Group

  • Primary Care Clinic/Center
  • Dallas, TX
  • NPI 1700333010
  Medicare reassignment NPD
• Paragon Pain & Rehabilitation PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Richardson, TX
  • NPI 1780958777
  Medicare reassignment NPD
• Irwin S. Korngut Mdpa

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1154611044
  NPD (past)

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1174084024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 BENTLEY CT",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034621",
            "telephone_number": "903-780-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 BENTLEY CT",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034621",
            "telephone_number": "903-780-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANTON",
        "first_name": "BRANDEN",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP140112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda R Blalock, NP
• Katelyn Michelle Blanchard, DDS, MSD
• Martin R Blanchard Jr., DC
• Holly Akin Blanco, M.D.
• Virginia Blankinship, FNP-C
• Kenneth Blanton
• Jason L. Blaser, MD
• Bianca Blattman, LPC-A
• Jonathan Blau, M.D.
• Julie Lane Blavier, D.C.

• Primary Care Nurse Practitioner in Tyler, TX
• Providers in Tyler, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.