Blythe Bankenbush, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

725 S Rural Rd Ste 120
Tempe, AZ 85281-2047

Phone

(480) 214-0622

NPI assigned

Sep 5, 2017

Last updated

Sep 30, 2021By 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

Other names 1

• Blythe Redman Former name

Medicare fee-for-service enrollment

Enrolled in CA, AZ2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Honorhealth-Fastmed Ambulatory Holdings LLC

  dba HonorHealth FastMed Urgent Care

  • Urgent Care Clinic/Center
  • Surprise, AZ
  • NPI 1467069047
  Medicare reassignment NPD (past)
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1518984210
  Medicare reassignment
• Mission Viejo Emergency Medical Associates

  • Emergency Medicine Physician
  • Mission Viejo, CA
  • NPI 1073542916
  Medicare reassignment
• Mission Viejo Emergency Medical Associates, Inc.

  • Emergency Medicine Physician
  • Laguna Beach, CA
  • NPI 1134355597
  Medicare reassignment
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Apache Junction, AZ
  • NPI 1205273406

  Physician Assistant

  NPD
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • San Tan Valley, AZ
  • NPI 1902936164

  Physician Assistant

  NPD
• Honorhealth-Fastmed Ambulatory Holdings LLC

  dba HonorHealth FastMed Urgent Care

  • Urgent Care Clinic/Center
  • Mesa, AZ
  • NPI 1578170114
  NPD
• Honorhealth-Fastmed Ambulatory Holdings LLC

  dba HonorHealth FastMed Urgent Care

  • Urgent Care Clinic/Center
  • Tucson, AZ
  • NPI 1801403480
  NPD

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1902324478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 ROSE PETAL ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933112975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S RURAL RD STE 120",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852812047",
            "telephone_number": "480-214-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKENBUSH",
        "first_name": "BLYTHE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-05",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLYTHE",
            "last_name": "REDMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Baldwin, DTR
• Steven Alex Baldwin, MD
• Jordan Ball
• John Balles, PH.D.
• Willie Benjamin Ballou, NP-C
• Carrie Susanne Bann, PMHNP-BC
• Banner Enticare Tempe Surgery Center LLC (Banner Tempe Surgery Center)
• Banner Health (Banner Health Clinic- Tempe)
• Banner Occupational Health - Onsite, LLC
• Banner Urgent Care Services, LLC

• Physician Assistant in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.