Individual provider Active NPI

Radford H Blankenship, D.C.

  • Chiropractor
  • Statesville, NC
National Provider Identifier
1992753529
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
717 Issued in NC
Practice address
1953 Wilkesboro Hwy
Statesville, NC 28625-8737
Phone
(704) 873-7068
Fax
(704) 871-9974
NPI assigned
May 5, 2006
Last updated
Aug 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 717 NC Primary

Addresses

Primary practice location

1953 Wilkesboro Hwy
Statesville, NC 28625-8737

Mailing address

1953 Wilkesboro Hwy
Statesville, NC 28625-8737
Phone (704) 873-7068

Other identifiers 1

IdentifierTypeStateIssuer
89013A0MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101214000775 NC Practitioner - Chiropractic 6002003589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1969
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1953 Wilkesboro Hwy
Statesville, NC 28625-8737
Phone (704) 873-7068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
717NCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blankenship Chiropractic Clinic, PA Chiropractor CurrentSince Sep 1, 1979 Accepting new patients

Locations

1953 Wilkesboro Hwy
Statesville, NC 28625
Phone (704) 873-7068

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1992753529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1953 WILKESBORO HWY",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258737",
            "telephone_number": "704-873-7068",
            "fax_number": "704-871-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1953 WILKESBORO HWY",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258737",
            "telephone_number": "704-873-7068",
            "fax_number": "704-871-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKENSHIP",
        "first_name": "RADFORD",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013A0",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.