Active NPI
Hal H Blank, CSA OPAC
- Surgical Technologist
- Plainfield, IN
National Provider Identifier
1396736070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Technologist
- License
- SA081
- Practice address
- 7073 Stonecreek Dr
Plainfield, IN 46168-7923 - Phone
- (317) 838-8999
- Fax
- (317) 838-8999
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 0000097 | NY | |
| Surgical Technologist | 246ZS0410X | SA081 | KY | Primary |
Addresses
Primary practice location
7073 Stonecreek Dr
Plainfield, IN 46168-7923
Mailing address
7073 Stonecreek Dr
Plainfield, IN 46168-7923
Phone (317) 838-8999
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0000097 | NY | MD | Specialist |
| SA081 | KY | MD | Surgical Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206057600000",
"number": "1396736070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7073 STONECREEK DR",
"city": "PLAINFIELD",
"state": "IN",
"postal_code": "461687923",
"telephone_number": "317-838-8999",
"fax_number": "317-838-8999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7073 STONECREEK DR",
"city": "PLAINFIELD",
"state": "IN",
"postal_code": "461687923",
"telephone_number": "317-838-8999",
"fax_number": "317-838-8999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANK",
"first_name": "HAL",
"middle_name": "H",
"name_prefix": "Mr.",
"credential": "CSA OPAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2008-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "0000097",
"primary": false
},
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "KY",
"license": "SA081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainfield, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.