EMMITT MATTHEW BLANKENSHIP (NPI# 1366891830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366891830 |
| Entity Type | Individual |
| Full Name | EMMITT MATTHEW BLANKENSHIP |
| Credential | PA-C |
| Practice Address |
1325 Eastmoreland Ave Ste 365 Memphis TN 38104-7542 |
| Mailing Address |
P O Box 1000 Dept 960 Memphis TN 38148-0001 |
| Practice Telephone | 9012726030 |
| Practice Fax Number | 9015168450 |
| Mailing Telephone | 9017630200 |
| Mailing Fax Number | 9012601704 |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2017-12-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 3404 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | C06210 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1325 EASTMORELAND AVE STE 365 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-7542 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407026859 | Belinda D Frost | Nurse Practitioner | 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104-7542 | 2008-02-29 |
| 1891340154 | Lauren Elizabeth Whitley | Physician Assistant | 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104-7542 | 2019-08-05 |
| 1518519057 | Michael Trevor Houseal | Physician Assistant | 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104-7542 | 2019-07-15 |
| 1073022133 | Fariborz A Yaghini | Nurse Practitioner | 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104-7542 | 2017-09-21 |
| 1265897789 | Justin B Cole | Physician Assistant | 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104-7542 | 2015-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235737354 | Adrienne Smith | Physician Assistant | 5200 Park Ave Ste 100, Memphis, TN 38119-3505 | 2020-10-12 |
| 1134734817 | Siushan Tang Vuong | Physician Assistant | 102 Clark Pl Apt S, Memphis, TN 38104-2419 | 2020-09-10 |
| 1174137525 | Gustavo Adolfo Tangarife Sr. | Physician Assistant | 2193 Morning Vista Dr, Memphis, TN 38134-6018 | 2020-09-02 |
| 1053949586 | Michella Glenna Douglas | Physician Assistant | 3911 Oak Branch Cir W, Memphis, TN 38135-0213 | 2020-03-30 |
| 1619508942 | Victoria Mackay | Physician Assistant | 595 Danny Thomas Place, Memphis, TN 38105 | 2020-01-27 |
| 1306480868 | Lauren Blum | Physician Assistant | 100 S Greer St, Memphis, TN 38111-3429 | 2019-10-28 |
| 1487135463 | Baron Surgical, Pllc | Physician Assistant | 4728 Spottswood Ave # 199, Memphis, TN 38117-4817 | 2018-08-27 |
| 1083139265 | Huda Alaeddin | Physician Assistant | 6584 Poplar Ave Ste 400, Memphis, TN 38138-3687 | 2017-08-08 |
| 1982076246 | Richard Randolph | Physician Assistant | 1094 River Isle Dr, Memphis, TN 38103-8870 | 2015-10-27 |
| 1962870808 | Sophia Garrison | Physician Assistant | 4562 Poplar Ave Ste 109, Memphis, TN 38117-7515 | 2015-09-09 |
| Find all providers in MEMPHIS | ||||
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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.