Beth M Blankenship, PTA/L

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.005251 Issued in IL

Practice address

8306 Saint Lukes Dr
Beardstown, IL 62618-8384

Phone

(217) 323-4055

NPI assigned

Dec 18, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1669944435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W CARROLL ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8306 SAINT LUKES DR",
            "city": "BEARDSTOWN",
            "state": "IL",
            "postal_code": "626188384",
            "telephone_number": "217-323-4055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "626 W Carroll St",
            "address_purpose": "LOCATION",
            "city": "Macomb",
            "state": "IL",
            "postal_code": "614552036",
            "country_code": "US",
            "telephone_number": "309-251-2331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "BETH",
        "middle_name": "M",
        "credential": "PTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.005251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Beardstown, IL
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.