Carmie Salina Blankenship, CFNP

Individual provider Active NPI Family Nurse Practitioner · Sardis, MS

NPI 1629329289 · NPPES record last updated Jun 4, 2013

Key facts

NPI
1629329289
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
R825148 (MS)
Practice address
124 S. Main St
Sardis, MS 38666
Phone
(662) 487-1064
Fax
(662) 487-1381
NPI assigned
Sep 24, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quick Care Clinic LLC (2 clinicians)

Practice addresses (Care Compare)

350 Sunset Dr
Grenada, MS 38901-4613
Phone (662) 307-2750

Hospital & facility affiliations

  • Vitalcaring Group Home health agency · Cleveland, MS · CCN 257016
  • Accentcare Home Health of Greenwood Home health agency · Greenwood, MS · CCN 257131
  • Mississippi Homecare of Eupora Home health agency · Eupora, MS · CCN 257122
  • University of Mississippi Medical Center- Grenada Hospital · Grenada, MS · CCN 250168

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150710000974 MS Practitioner - Nurse Practitioner 8820309610 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R825148MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quick Care Clinic LLC Current
since Feb 28, 2015
Accepting new patients
C and K Pharmacy Past
since Sep 5, 2021
Accepting new patients

Locations

350 Sunset Dr
Grenada, MS 38901
Phone (662) 307-2221

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R825148 MS Yes

Addresses

Primary practice location

124 S. Main St
Sardis, MS 38666

Mailing address

124 S. Main St
Sardis, MS 38666
Phone (662) 487-1064

Other providers in Sardis, MS

All providers in Sardis, MS · Family Nurse Practitioner in Mississippi

Sources for this page

Verify at the official NPI Registry.