David Emil Blankenship II, DO

Individual provider Active NPI Internal Medicine Physician · Des Moines, IA

NPI 1982309324 · NPPES record last updated Jun 12, 2023

Key facts

NPI
1982309324
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
R-12864 (IA)
Practice address
1111 6TH Ave
Des Moines, IA 50314-2613
Phone
(515) 643-2261
Fax
(515) 643-5802
NPI assigned
Apr 4, 2023
Sex
Male
Sole proprietor
No

Medicare Care Compare profile

Specialty
Internal Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1901 Campus PL
Louisville, KY 40299-2308

500 W Jefferson St
Suite 2310
Louisville, KY 40202-2881

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230616001475 IA Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
0244698660

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R-12864IAMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X R-12864 IA Yes

Addresses

Primary practice location

1111 6TH Ave
Des Moines, IA 50314-2613

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-2261

Other providers in Des Moines, IA

All providers in Des Moines, IA · Internal Medicine Physician in Iowa

Sources for this page

Verify at the official NPI Registry.