Individual provider Active NPI

Malisa Blankenship

  • Physician Assistant
  • Dayton, OH
National Provider Identifier
1952114670
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.009283RX Issued in OH
Practice address
30 E Apple St Ste 1480
Dayton, OH 45409-2939
Phone
(937) 208-3220
NPI assigned
Jan 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.009283RX OH Primary

Addresses

Primary practice location

30 E Apple St Ste 1480
Dayton, OH 45409-2939

Mailing address

30 E Apple St Ste 1480
Dayton, OH 45409-2939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20250213002484 OH Practitioner - Physician Assistant 0941730352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722

1 Wyoming St
Berry Women'S Center Labor and Delivery
Dayton, OH 45409-2939
Phone (937) 439-4381

30 E Apple St
Dayton, OH 45409-2939

450 N Hyatt St
Suite 304
Tipp City, OH 45371-1433
Phone (937) 832-4773

Hospital & facility affiliations

  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Upper Valley Medical Center Hospital, Troy, OH, CCN 360174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Feb 26, 2025 Accepting new patients
Premier Health Specialists Inc CurrentSince Feb 26, 2025 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

30 E Apple St
Ste 1480
Dayton, OH 45409
Phone (937) 208-3220

3170 Kettering Blvd
Moraine, OH 45439
Phone (937) 208-6400

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Organizations & group practices 4

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 2

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": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1952114670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST STE 1480",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST STE 1480",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939",
            "telephone_number": "937-208-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "MALISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.009283RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.