Jill Caroland Blasingame, DTR

Primary specialty

Registered Dietetic TechnicianTaxonomy code 136A00000X

License

1092925 Issued in TN

Practice address

116 N Pauline St
Memphis, TN 38104-1005

Phone

(901) 523-4952

NPI assigned

Jul 8, 2024

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": "1720396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1730925983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 N PAULINE ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381041005",
            "telephone_number": "901-523-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 N PAULINE ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381041005",
            "telephone_number": "901-523-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASINGAME",
        "first_name": "JILL",
        "middle_name": "CAROLAND",
        "credential": "DTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "",
            "desc": "Dietetic Technician, Registered",
            "state": "TN",
            "license": "1092925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penelope Bland
• Trina Londra Bland, M.S.,CCC-SLP
• Emmitt Matthew Blankenship, PA-C
• Mona Victoria Adams Blankenship, MD
• Karen Deshun Blanton, BA
• James W Blatchford, M.D.
• Martha Blatchford, CRNA
• Peter James Blatz, MD
• Emma Blau, MA
• Ingrid Marie Blay Cantrell

• Registered Dietetic Technician in Memphis, TN
• Providers in Memphis, TN by specialty
• Registered Dietetic Technician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.