Luke Johnathan Blankenheim, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0004416 Issued in MD

Practice address

8926 Woodyard Rd
Suite 701
Clinton, MD 20735-4220

Phone

(301) 856-1682

Fax

(301) 856-8214

NPI assigned

Jan 31, 2011

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Greater Metropolitan Orthopaedics

  • Orthopaedic Surgery Physician
  • Clinton, MD
  • NPI 1205854767
  NPD (past)

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1174829774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8926 WOODYARD RD",
            "address_2": "SUITE 701",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354220",
            "telephone_number": "301-856-1682",
            "fax_number": "301-856-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8926 WOODYARD RD",
            "address_2": "SUITE 701",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207354220",
            "telephone_number": "301-856-1682",
            "fax_number": "301-856-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENHEIM",
        "first_name": "LUKE",
        "middle_name": "JOHNATHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-31",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0004416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PTAN",
            "identifier": "CI2264",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND LICENSE",
            "identifier": "C0004416",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE INDIVIDUAL PTAN",
            "identifier": "P00992732",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chandrakant K Bhatia, M.D.
• Bio-Medical Applications of Maryland Inc.
• Terrace Lamechia Diane Blake, LGPC
• Daniel Blakemore, RN
• Kimberly Bland
• Bleach and Associates, LLC
• Gail Bleach, PH.D.
• Seymour Howard Bloom, DDS
• Blooms Health Care Services LLC
• Blossom Home Care Services LLC

• Physician Assistant in Clinton, MD
• Providers in Clinton, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.