Nicholas William Blank, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301107544 Issued in MI

Practice address

2585 W Houghton Lake Dr
Prudenville, MI 48651-9624

Phone

(989) 366-2900

NPI assigned

Jun 15, 2015

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan State University College of Human Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Health HospitalsGroup PAC ID 8921904764, 161 clinicians

Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Spectrum Health UnitedGroup PAC ID 6305836487, 90 clinicians

Munson Healthcare GraylingGroup PAC ID 2062736655, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Healthcare Grayling Hospital Hospital, Grayling, MI, CCN 230058
• Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nblank@direct.mhc.net
• Direct secure messaging: nblank78369@epic00.corewelldirect.org

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.

• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151

  MI

  Medicare reassignment Care Compare group NPD
• Munson Healthcare Grayling

  • Rural Health Clinic/Center
  • Roscommon, MI
  • NPI 1710383351

  MI

  Medicare reassignment Care Compare group NPD
• Spectrum Health Hospitals

  • Hospitalist Physician
  • Grand Rapids, MI
  • NPI 1558407189

  MI

  Medicare reassignment Care Compare group NPD
• Spectrum Health United

  • General Acute Care Hospital
  • Greenville, MI
  • NPI 1457304495

  MI

  Medicare reassignment Care Compare group NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673

  MI

  Medicare reassignment NPD
• Munson Healthcare Grayling

  • Rural Health Clinic/Center
  • Mio, MI
  • NPI 1093349698
  Care Compare group NPD
• Munson Healthcare Grayling

  • Rural Health Clinic/Center
  • Grayling, MI
  • NPI 1891191698
  Care Compare group NPD
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare group NPD
• Munson Healthcare Grayling

  • Rural Health Clinic/Center
  • Prudenville, MI
  • NPI 1144626052
  Care Compare group NPD (past)
• Munson Healthcare Grayling

  • Rural Acute Care Hospital
  • Grayling, MI
  • NPI 1083010953
  Care Compare group
• Munson Healthcare Grayling

  • Family Medicine Physician
  • Grayling, MI
  • NPI 1699275750
  Care Compare group
• Munson Healthcare Grayling

  • Skilled Nursing Facility
  • Grayling, MI
  • NPI 1720484504
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Healthcare Grayling

  • Rural Acute Care Hospital
  • Grayling, MI
  • NPI 1083010953

  Hospital

  Care Compare affiliation
• Saint Mary'S Health Services

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1275914244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4081 CASCADE RD SE STE 600",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462170",
            "telephone_number": "616-267-0800",
            "fax_number": "888-690-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 W HOUGHTON LAKE DR",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "486519624",
            "telephone_number": "989-366-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497381312",
            "country_code": "US",
            "telephone_number": "989-348-5461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497387074",
            "country_code": "US",
            "telephone_number": "989-348-0550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "234 Lake St",
            "address_purpose": "LOCATION",
            "city": "Roscommon",
            "state": "MI",
            "postal_code": "486539203",
            "country_code": "US",
            "telephone_number": "989-275-1200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4081 Cascade Rd SE Ste 600",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495462170",
            "country_code": "US",
            "telephone_number": "616-267-0800",
            "fax_number": "888-690-4412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANK",
        "first_name": "NICHOLAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301107544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nblank@direct.mhc.net",
            "affiliation": "N",
            "address_1": "1250 E Michigan Ave",
            "city": "Grayling",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497387074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Karalee Celeste Beemer
• Brittany Bevill
• Jordan Seth Bishop
• Christopher Michael Black
• Suzanne A Blanchard, NP
• Shane Dennis Bliss
• Hailie Ann Boals I
• Natasha Lynn Bock
• Louis E Boggs, O.D.
• Paige Marie Bowman

• All providers in Prudenville, MI
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.