Gregory W Blank, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001629 Issued in IA

Practice address

250 S Crescent Dr
Mason City, IA 50401-2926

Phone

(641) 422-6730

Fax

(641) 422-6659

NPI assigned

Feb 3, 2006

Last updated

Feb 17, 2009By the provider in NPPES

Sex

Male

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)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prairie Cardiovascular Consultants LTD

  • Multi-Specialty Clinic/Center
  • Springfield, IL
  • NPI 1982714218
  NPD (past)

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234828800000",
    "number": "1831161736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S CRESCENT DR",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012926",
            "telephone_number": "641-422-6730",
            "fax_number": "641-422-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S CRESCENT DR",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012926",
            "telephone_number": "641-422-6730",
            "fax_number": "641-422-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "GREGORY",
        "middle_name": "W",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2009-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittani Bjelland, PHARM.D.
• Stephen Daniel Blackman, B.A.
• Michael Adams Blackmore, M.D.
• Bladder Control Solutions, LLC
• David B Blaha, PHARM.D.
• Connie A Bleile, LISW
• Bloom Counseling Services LLC
• John L Boedeker, DO
• Sadie Bohl
• Michelle Rae Boldt, LMHC-T

• Physician Assistant in Mason City, IA
• Providers in Mason City, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.