Active NPI
Marion Catharine Blankenship, DDS
- Dentist
- Petersburg, WV
National Provider Identifier
1346655057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4113
- Practice address
- 65 Hospital Dr
Suite 5
Petersburg, WV 26847-9549 - Phone
- (304) 257-4593
- Fax
- (304) 530-5160
- NPI assigned
- Jun 23, 2014
- Last updated
- Jun 23, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4113 | WV | Primary |
Addresses
Primary practice location
65 Hospital Dr
Suite 5
Petersburg, WV 26847-9549
Mailing address
PO Box 97
Baker, WV 26801-0097
Phone (304) 897-5915
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150630000483 | WV | Order and Referring Only - Dentist | 1052623386 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403481600000",
"number": "1346655057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 97",
"city": "BAKER",
"state": "WV",
"postal_code": "268010097",
"telephone_number": "304-897-5915",
"fax_number": "304-897-6216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 HOSPITAL DR",
"address_2": "SUITE 5",
"city": "PETERSBURG",
"state": "WV",
"postal_code": "268479549",
"telephone_number": "304-257-4593",
"fax_number": "304-530-5160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANKENSHIP",
"first_name": "MARION",
"middle_name": "CATHARINE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-23",
"last_updated": "2014-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "4113",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petersburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.