Individual provider Active NPI

Jennifer L. Blankenship, WHCNP

  • Women's Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1457417230
Registry record updated May 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
643191 Issued in TX
Practice address
8224 Park LN Ste 130
Vickery Health Center
Dallas, TX 75231-6021
Phone
(214) 266-0266
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 643191 TX Primary

Addresses

Primary practice location

8224 Park LN Ste 130
Vickery Health Center
Dallas, TX 75231-6021

Mailing address

PO Box 660599
Dallas, TX 75266-0599

Other identifiers 12

IdentifierTypeStateIssuer
145299705MedicaidTX
145299709MedicaidTX
145299702MedicaidTX
145299704MedicaidTX
145299701MedicaidTX
145299711MedicaidTX
145299703MedicaidTX
145299708MedicaidTX
8Y1540OtherTXBLUE CROSS BLUE SHIELD
145299706MedicaidTX
145299707MedicaidTX
145299710MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100514000211 TX Practitioner - Nurse Practitioner 7416085238 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Hospital District Women'S Health CurrentSince Mar 1, 2010 Accepting new patients
Dallas County Hospital District Women'S Health CurrentSince Mar 1, 2010 Accepting new patients
Dallas County Hospital District Women'S Health Current Accepting new patients

Locations

6300 Harry Hines Blvd
Ste 600
Dallas, TX 75235
Phone (214) 266-0130

8224 Park Ln
Ste 130
Dallas, TX 75231
Phone (214) 266-0266

1800 N Britain Rd
Irving, TX 75061
Phone (214) 266-3000

Interoperability endpoints

  • Direct secure messaging: jblankenship12080@direct.phhs.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242172800000",
    "number": "1457417230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660599",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8224 PARK LN STE 130",
            "address_2": "VICKERY HEALTH CENTER",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752316021",
            "telephone_number": "214-266-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "credential": "WHCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2009-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "643191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299705",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299709",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299704",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299711",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299703",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299708",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8Y1540",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299706",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299707",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145299710",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.