Maire M Blankenship, APRN
Individual provider Active NPI Family Nurse Practitioner · Bowling Green, KY
NPI 1497050645 · NPPES record last updated Mar 9, 2018
Key facts
- NPI
- 1497050645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3006706 (KY)
- Practice address
- 201 Park St
Bowling Green, KY 42101-1759 - Phone
- (270) 781-5111
- Fax
- (270) 780-0474
- NPI assigned
- Jan 19, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Graves Gilbert Clinic PLLC
Practice addresses (Care Compare)
201 Park St
Bowling Green, KY 42101-1742
Phone (270) 781-5111
Hospital & facility affiliations
- The Medical Center (Bowling Green)
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130430000669 | KY | Practitioner - Nurse Practitioner | 4880831312 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3006706 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Graves Gilbert Clinic PLLC | Current |
Accepting new patients | |
| Graves Gilbert Clinic PLLC | Current |
Accepting new patients |
Locations
201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229
Interoperability endpoints
- marie.blankenship@ggclinic.ikm.direct-ci.com
- maireblankenship@ggc.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3006706 | KY | Yes |
Addresses
Primary practice location
201 Park St
Bowling Green, KY 42101-1759
Mailing address
201 Park St
Bowling Green, KY 42101-1759
Phone (270) 781-5111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100238060 | Medicaid | KY |
Other providers in Bowling Green, KY
- Kevin R Blalock
- Autumn Bland
- Shannon G Blandford
- Alyzea Blankenship
- Kristin Marie Blankenship
- Kendal Lashea Bledsoe
- Morgan Deann Blevins
- Thomas J Blevins
- Blue Atlas LLC
- Bluegrass Counseling & Wellness
All providers in Bowling Green, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.