Organization Active NPI

Blane Clinical LLC

  • Multi-Specialty Clinic/Center
  • Dover, TN
National Provider Identifier
1730906348
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BLANE CLINICAL LLC
Practice address
1307 Donelson Pkwy
Dover, TN 37058-3724
Phone
(931) 232-0123
Fax
(931) 232-1185
NPI assigned
Sep 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Marlin BlaneNPI 1447662143
Title
Ao
Phone
(312) 820-1126

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Multi-Specialty Clinic/Center 261QM1300X Primary
Clinic Pharmacy 3336C0002X

Addresses

Primary practice location

1307 Donelson Pkwy
Dover, TN 37058-3724

Mailing address

1307 Donelson Pkwy
Dover, TN 37058-3724
Phone (931) 232-0123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251023001852 TN Part B Supplier - Clinic/Group Practice 6305334129 Receives reassigned benefits from 1 practitioner
Practice locations: Dover, TN

National Provider Directory

National Provider Directory

Locations

1307 Donelson Pkwy
Dover, TN 37058
Phone (931) 232-0123

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1730906348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 DONELSON PKWY",
            "city": "DOVER",
            "state": "TN",
            "postal_code": "370583724",
            "telephone_number": "931-232-0123",
            "fax_number": "931-232-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 DONELSON PKWY",
            "city": "DOVER",
            "state": "TN",
            "postal_code": "370583724",
            "telephone_number": "931-232-0123",
            "fax_number": "931-232-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANE CLINICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "BLANE",
        "authorized_official_first_name": "MARLIN",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "312-820-1126"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.