BRAD D. BLANKENHORN (NPI# 1003033119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003033119 |
| Entity Type | Individual |
| Full Name | BRAD D. BLANKENHORN |
| Credential | M.D. |
| Practice Address |
1 Kettle Point Ave East Providence RI 02914-5375 |
| Mailing Address |
Po Box 1119 Providence RI 02901-1119 |
| Practice Telephone | 4013301405 |
| Practice Fax Number | 4012770799 |
| Mailing Telephone | 4013301405 |
| Mailing Fax Number | 4012770799 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2019-02-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 2012-0546 | NM | Allopathic & Osteopathic Physicians |
| Y | 207X00000X | Orthopaedic Surgery | MD13206 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | MASSHEALTH | 110087299A | 01 |
| RI | BB81009 | 05 |
| Street Address |
1 KETTLE POINT AVE |
| City | EAST PROVIDENCE |
| State | RI |
| Zip Code | 02914-5375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467443051 | Brett D Owens | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2005-11-02 |
| 1124642285 | Kyra Gabow | Physician Assistant | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2020-06-04 |
| 1033742564 | Danielle Barry | Nurse Practitioner | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2020-02-12 |
| 1558991737 | Chloe Hawkridge Sienkewicz | Physician Assistant | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2020-01-16 |
| 1972162113 | Kirsten Harrington | Physician Assistant | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2019-06-11 |
| 1093373888 | Melissa Viens | Occupational Therapist | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2019-06-05 |
| 1184184012 | Kasey Elizabeth Cameron | Physician Assistant | 1 Kettle Point Ave, East Providence, RI 02914 | 2019-03-25 |
| 1417452442 | Michael Coyne | Physical Therapist | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2018-03-30 |
| 1932608692 | Jason R Schoenfelder | Physical Therapist | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2018-02-08 |
| 1811413404 | University Orthopedics, Inc. | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2017-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457988198 | Sean C. Duffy | Massage Therapist | 231 Warren Ave., East Providence, RI 02914 | 2020-03-24 |
| 1457905606 | Jeanine Le-kreuzer, Lmhc | Clinic/Center | 3421 Pawtucket Ave, East Providence, RI 02914 | 2019-07-26 |
| 1881113983 | Megan Grace Fitzpatrick | Student in an Organized Health Care Education/Training Program | 51 Milburn Rd, East Providence, RI 02914 | 2017-09-11 |
| 1265719660 | Hilary Elise Bicknell | Physical Therapist | 927 B Warren Ave, East Providence, RI 02914 | 2011-11-14 |
| 1346549037 | Amanda M Hope | Occupational Therapist | 2680 Pawtucket Ave, East Providence, RI 02914 | 2011-03-21 |
| 1780993824 | Shannon Hayes | Physical Therapist | 400 Massaoit Ave, East Providence, RI 02914 | 2010-10-06 |
| 1053623538 | Ricardo Rafael Correa Marquez | Internal Medicine | 900 Warren Avenue, Suite 300, East Providence, RI 02914 | 2010-07-13 |
| 1013231570 | Michael Seidler | Internal Medicine | 20 Catamore Blvd., East Providence, RI 02914 | 2010-03-26 |
| 1053543405 | Ray Rezania | Dentist | 1055 South Broadway, East Providence, RI 02914 | 2009-08-19 |
| 1144464587 | John F Maynard | Urology | Metacomet Office Park, 450 Veterans Parkway, East Providence, RI 02914 | 2009-04-29 |
| Find all providers in zip 02914 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467443051 | Brett D Owens | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2005-11-02 |
| 1811413404 | University Orthopedics, Inc. | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2017-08-16 |
| 1255711370 | David Clayton Tapscott | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2015-06-03 |
| 1528454519 | Andrew Howard Gage | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2015-04-07 |
| 1700271137 | Arthur Manoli IIi | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2015-04-02 |
| 1861887440 | Vamsy Bobba | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2015-04-01 |
| 1700204492 | John Andrew Younghein | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2014-03-31 |
| 1275970303 | Dominic Kleinhenz | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2013-05-30 |
| 1619313723 | Eren Kuris | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2013-05-15 |
| 1962846931 | Andrew Zhang | Orthopaedic Surgery | 1 Kettle Point Ave, East Providence, RI 02914-5375 | 2013-04-22 |
| Find all providers in EAST PROVIDENCE | ||||
| City | EAST PROVIDENCE |
| Zip Code | 02914 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.