Shelby Larue Blank, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME95568 Issued in FL

Practice address

1401 Centerville Rd Ste G02
Tallahassee, FL 32308-4638

Phone

(850) 431-2100

Fax

(850) 431-2199

NPI assigned

Jun 6, 2006

Last updated

Mar 29, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

General Surgery

Education

University of South Florida College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tallahassee Memorial Healthcare IncGroup PAC ID 6103724778, 498 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sblank21417@tallahasseememorial.direct-ci.com
• Direct secure messaging: shelbyblank@tmhpp.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Medicare reassignment Care Compare group NPD
• Tallahassee Memorial Healthcare Inc

  • Internal Medicine Physician
  • Tallahassee, FL
  • NPI 1487932422
  NPD
• Tallahassee Memorial Healthcare Inc

  dba TMHPP Anesthesiology PCB

  • Anesthesiology Physician
  • Panama City Beach, FL
  • NPI 1992532477
  NPD
• Doctors Memorial Hospital Inc

  dba DMH Family Practice

  • Rural Health Clinic/Center
  • Perry, FL
  • NPI 1457399982
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522281600000",
    "number": "1447299979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE RD STE G02",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084638",
            "telephone_number": "850-431-2100",
            "fax_number": "850-431-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CENTERVILLE RD STE G02",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084638",
            "telephone_number": "850-431-2100",
            "fax_number": "850-431-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "SHELBY",
        "middle_name": "LARUE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2018-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME95568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fitz Blake Jr.
• Kai Danare Blake, DPT
• Raven Blake
• Shana Lesti Blakeney, CNFP
• Kristen Taylor Bland, APRN
• Allison Paige Blankenship, PHD
• Tammy L Blankenship, MD, MPH, MS
• Zaquez Blankumsee
• Byron Blasko, ARNP
• Dustin Ryan Bledsoe, D.C.

• Surgery Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.