Individual provider Active NPI

Jackie L Blankenship, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1750179693
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1056941 Issued in TX
Practice address
1600 Wallace Blvd
Amarillo, TX 79106-1789
Phone
(806) 212-2129
NPI assigned
Apr 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1056941 TX Primary

Addresses

Primary practice location

1600 Wallace Blvd
Amarillo, TX 79106-1789

Mailing address

1600 Wallace Blvd
Amarillo, TX 79106-1789
Phone (806) 212-2129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250530001103 TX Practitioner - Nurse Practitioner 8628587821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bsa Physicians Group IncGroup PAC ID 3971748146, 121 clinicians

Practice addresses (Care Compare)

1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 212-2129

Hospital & facility affiliations

  • Bsa Hospital Hospital, Amarillo, TX, CCN 450231
  • Pampa Regional Medical Center Hospital, Pampa, TX, CCN 451398
  • Dr Dan C Trigg Memorial Hospital Hospital, Tucumcari, NM, CCN 321302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bsa Physicians Group Inc CurrentSince Apr 29, 2025 Accepting new patients
Bsa Physicians Group Inc CurrentSince Apr 29, 2025 Accepting new patients

Locations

1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000

1751 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2129

Interoperability endpoints

  • Direct secure messaging: jblankenship358629@ahs.direct-ci.com

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1750179693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061789",
            "telephone_number": "806-212-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WALLACE BLVD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061789",
            "telephone_number": "806-212-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "JACKIE",
        "middle_name": "L",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1056941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.