Mary Jo Blanton, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20157 Issued in TN

Practice address

36 Pemberton CV
Jackson, TN 38305-5514

Phone

(731) 394-1145

NPI assigned

Jul 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mary.blanton@488678167609348.direct.elationemr.com

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.

• First Choice Health, Inc

  • Ambulatory Surgical Clinic/Center
  • Natchez, MS
  • NPI 1154403350
  NPD (past)
• Natchez After Hours Clinic, P.L.L.C.

  • General Practice Physician
  • Natchez, MS
  • NPI 1982634051
  NPD (past)
• Scott F.Steed MD PA

  • Anesthesiology Physician
  • Natchez, MS
  • NPI 1023167558
  NPD (past)
• University Internal Medicine Assoc LLP

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1083656870
  NPD (past)

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1497784466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 PEMBERTON CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055514",
            "telephone_number": "731-394-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 PEMBERTON CV",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383055514",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANTON",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R858448",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01674813",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Blake, RBT
• Jeremy T. Blake, M.D.
• Jase Blakney, PTA
• Derek Blankenship, PA-C
• Joe David Blankenship, M.D.
• BLC Jackson Oaks, LLC
• Bethany Paige Bledsoe, LCSW
• Toni Blocker
• Tyler Blocker, CRNA
• Elizabeth Andrea Blow, RD

• Family Nurse Practitioner in Jackson, TN
• Providers in Jackson, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.