Tabula Rasa, PLLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

19121 Issued in WV

Legal business name

TABULA RASA, PLLC

Practice address

1296 Robert C. Byrd Drive
Crab Orchard, WV 25827

Phone

(681) 238-5957

Fax

(681) 238-5958

NPI assigned

Mar 6, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Blankenship, M.D.

Title

Owner

Phone

(681) 238-5957

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Warren Sturgill, MA MSW LPC LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Crab Orchard, WV
  • NPI 1417432287
  NPD (past)

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1407396773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "258270415",
            "telephone_number": "681-238-5957",
            "fax_number": "681-238-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1296 ROBERT C. BYRD DRIVE",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "25827",
            "telephone_number": "681-238-5957",
            "fax_number": "681-238-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABULA RASA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "681-238-5957",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WV",
            "license": "19121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doris Snuffer
• Maniya Stevens, BS
• Lauren Stuart, COTA/L
• Steven Warren Sturgill, MA MSW LPC LCSW
• Jessica Lynn Sumpter, BA.
• Tabula Rasa, PLLC
• Judith Karen Thompson
• Vaught Infusion Services, PLLC
• Vaught Neurological Services
• Barry K Vaught, M.D.

• Preferred Provider Organization in Crab Orchard, WV
• Providers in Crab Orchard, WV by specialty
• Preferred Provider Organization in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.