Individual provider Active NPI

David Scott Blankenberg, OTR/L

  • Occupational Therapist
  • Grand Island, NY
National Provider Identifier
1194977769
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
63011718 Issued in NY
Practice address
76 Carol LN
Grand Island, NY 14072-2805
Phone
(716) 517-6048
NPI assigned
Oct 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 63011718 NY Primary

Addresses

Primary practice location

76 Carol LN
Grand Island, NY 14072-2805

Mailing address

76 Carol LN
Grand Island, NY 14072-2805
Phone (716) 517-6048

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
63011718NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1194977769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 CAROL LN",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140722805",
            "telephone_number": "716-517-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 CAROL LN",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "140722805",
            "telephone_number": "716-517-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENBERG",
        "first_name": "DAVID",
        "middle_name": "SCOTT",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-15",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "63011718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.