Organization Active NPI

Jennifer L. Blankenship, L.C.S.W., P.C.

  • Clinical Social Worker
  • Abingdon, VA
National Provider Identifier
1750434718
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904003921 Issued in VA
Legal business name
JENNIFER L. BLANKENSHIP, L.C.S.W., P.C.
Practice address
335 E Main St
Abingdon, VA 24210-2905
Phone
(276) 628-2510
Fax
(276) 628-9594
NPI assigned
Jan 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Authorized official

Name
Jennifer Lenore BlankenshipNPI 1033219605
Title
Business Owner
Phone
(276) 628-2510

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 0904003921 VA Primary

Addresses

Primary practice location

335 E Main St
Abingdon, VA 24210-2905

Mailing address

PO Box 985
Abingdon, VA 24212-0985
Phone (276) 628-2510

Other identifiers 1

IdentifierTypeStateIssuer
256926OtherVAANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040708000011 VA Part B Supplier - Clinic/Group Practice 9739167784 Receives reassigned benefits from 1 practitioner
Practice locations: Abingdon, VA

National Provider Directory

National Provider Directory

Locations

699 McBroom St NW
Ste B
Abingdon, VA 24210
Phone (276) 492-8421

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": "1169251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1750434718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 985",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242120985",
            "telephone_number": "276-628-2510",
            "fax_number": "276-628-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 E MAIN ST",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102905",
            "telephone_number": "276-628-2510",
            "fax_number": "276-628-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER L. BLANKENSHIP, L.C.S.W., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-20",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LENORE",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "276-628-2510"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "256926",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.