Tabula Rasa, PLLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

AP00943133 Issued in WV

Legal business name

TABULA RASA, PLLC

Practice address

1296 Robert C. Byrd Dr
Crab Orchard, WV 25827

Phone

(681) 238-5957

Fax

(681) 238-5958

NPI assigned

Feb 20, 2017

Organization subpart

No

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

Authorized official

Name

Kevin Blankenship, M.D.NPI 1003815515

Title

Director

Phone

(681) 238-5957

Specialties & licenses 1

Addresses

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin J Blankenship, MD

  • Emergency Medicine Physician
  • Morgantown, WV
  • NPI 1003815515
  NPD (past) Authorized official
• Brooke Blankenship, MSW,LSW

  • Addiction (Substance Use Disorder) Counselor
  • Crab Orchard, WV
  • NPI 1578003646
  NPD (past)
• Traci Lynn Morris, NP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Beckley, WV
  • NPI 1043564636
  NPD (past)
• Steven Warren Sturgill, MA MSW LPC LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Crab Orchard, WV
  • NPI 1417432287
  NPD (past)

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1730628025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "258270415",
            "telephone_number": "681-238-5957",
            "fax_number": "681-238-5958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1296 ROBERT C. BYRD DR",
            "city": "CRAB ORCHARD",
            "state": "WV",
            "postal_code": "25827",
            "telephone_number": "681-238-5957",
            "fax_number": "681-238-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABULA RASA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "681-238-5957",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "WV",
            "license": "AP00943133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maniya Stevens, BS
• Lauren Stuart, COTA/L
• Steven Warren Sturgill, MA MSW LPC LCSW
• Jessica Lynn Sumpter, BA.
• Tabula Rasa, PLLC
• Judith Karen Thompson
• Vaught Infusion Services, PLLC
• Vaught Neurological Services
• Barry K Vaught, M.D.
• Sandra White

• Exclusive Provider Organization in Crab Orchard, WV
• Providers in Crab Orchard, WV by specialty
• Exclusive Provider Organization in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.