Laney Revae Blankenship

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA4834 Issued in AR

Practice address

115 N 14TH St
Paragould, AR 72450

Phone

(870) 476-9017

Fax

(870) 362-2018

NPI assigned

Sep 18, 2023

Last updated

Sep 18, 2023By the provider in NPPES

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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1821876269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 STONEGATE DRIVE",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "72450",
            "telephone_number": "870-450-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N 14TH ST",
            "city": "PARAGOULD",
            "state": "AR",
            "postal_code": "72450",
            "telephone_number": "870-476-9017",
            "fax_number": "870-362-2018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "LANEY",
        "middle_name": "REVAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "PTA4834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bibb Chiropractic Center Inc
• John G Bibb, D.C.
• Carrah R Bird
• Amber Blackburn
• Gage Blankenship
• Tana Blevins
• Bret Tyler Bloodworth, OTD R/L
• Amanda Blue, MHPP
• Whitley Nicole Blue, RN
• Marshia Jean Bobo, AA CDA MHPP

• Physical Therapy Assistant in Paragould, AR
• Providers in Paragould, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.