Individual provider Active NPI

Wesley Shane Blankenship, LPTA

  • Physical Therapy Assistant
  • Bluefield, VA
National Provider Identifier
1982949269
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306601383 Issued in VA
Practice address
20 Westwood Medical Park
Bluefield, VA 24605-2003
Phone
(276) 322-5439
NPI assigned
Nov 28, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306601383 VA Primary

Addresses

Primary practice location

20 Westwood Medical Park
Bluefield, VA 24605-2003

Mailing address

20 Westwood Medical Park
Bluefield, VA 24605-2003
Phone (276) 322-5439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2306601383VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1982949269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WESTWOOD MEDICAL PARK",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "246052003",
            "telephone_number": "276-322-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WESTWOOD MEDICAL PARK",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "246052003",
            "telephone_number": "276-322-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "WESLEY",
        "middle_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306601383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluefield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.