LUKE JOHNATHAN BLANKENHEIM (NPI# 1174829774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174829774 |
| Entity Type | Individual |
| Full Name | LUKE JOHNATHAN BLANKENHEIM |
| Credential | PA-C |
| Practice Address |
8926 Woodyard Rd Suite 701 Clinton MD 20735-4220 |
| Practice Telephone | 3018561682 |
| Practice Fax Number | 3018568214 |
| Mailing Telephone | 3018561682 |
| Mailing Fax Number | 3018568214 |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2012-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | C0004416 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MARYLAND LICENSE | C0004416 | 01 | |
| RAILROAD MEDICARE INDIVIDUAL PTAN | P00992732 | 01 | |
| RAILROAD MEDICARE GROUP PTAN | CI2264 | 01 |
| Street Address |
8926 WOODYARD RD SUITE 701 |
| City | CLINTON |
| State | MD |
| Zip Code | 20735-4220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215933221 | David J Haidak | Internal Medicine | 8926 Woodyard Rd, Ste 201, Clinton, MD 20735-4231 | 2005-06-23 |
| 1003358201 | Diana Carrera | Student in an Organized Health Care Education/Training Program | 8926 Woodyard Rd, Suite 501, Clinton, MD 20735-4220 | 2016-11-06 |
| 1952788580 | National Rehabilitation Hospital, Inc. | Physical Therapist | 8926 Woodyard Rd, Suite 501, Clinton, MD 20735 | 2015-05-04 |
| 1295133528 | Mgmc, LLC | General Practice | 8926 Woodyard Rd, Suite 602, Clinton, MD 20735-4220 | 2014-12-19 |
| 1356740278 | Tosin Fagbemi | Physical Therapist | 8926 Woodyard Rd, Suite 501, Clinton, MD 20735-4220 | 2014-08-15 |
| 1851721773 | Kelli Stewart-johnson | Physical Therapy Assistant | 8926 Woodyard Rd, 701, Clinton, MD 20735-4220 | 2013-11-13 |
| 1548506488 | Chaney Widmer | Genetic Counselor, MS | 8926 Woodyard Rd, Suite 601, Clinton, MD 20735-4220 | 2012-12-21 |
| 1255682589 | Tinsley Simonds Iselin | Physician Assistant | 8926 Woodyard Rd, Suite 701, Clinton, MD 20735-4220 | 2012-09-26 |
| 1821399239 | Timothy Justin Miller | Specialist | 8926 Woodyard Rd, Ste 301, Clinton, MD 20735-4220 | 2010-11-16 |
| 1184930885 | Greater Metropolitan Orthopaedics | Orthopaedic Surgery | 8926 Woodyard Rd, Suite 701, Clinton, MD 20735-4220 | 2010-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940456 | Elise Olson | Occupational Therapist | 9135 Piscataway Rd, Suite 305, Clinton, MD 20735 | 2019-03-12 |
| 1437651742 | Total You Integrative Healthcare Inc | Clinic/Center | 9135 Piscataway Rd Ste 410, Clinton, MD 20735 | 2018-03-02 |
| 1386193233 | Benedicta C Osamor | Home Health Aide | 6808 Purple Lilac Ln, Clinton, MD 20735 | 2016-10-03 |
| 1669926309 | Frankline Ngozi Obi I | Home Health Aide | 8111 Highland Meadows Dr, Clinton, MD 20735 | 2016-08-11 |
| 1770952459 | Adventures One, Inc. | Clinic/Center | 7121 Old Alexandria Ferry Rd., Clinton, MD 20735 | 2015-09-23 |
| 1730574831 | Lindsey Degeorge | Emergency Medicine | 7503 Surratts Rd Dept Of, Clinton, MD 20735 | 2015-04-06 |
| 1316341860 | Margaret Laurence-whitlock | Speech-Language Pathologist | 5807 Terence Dr., Laurence Learning Center, Clinton, MD 20735 | 2014-10-13 |
| 1699103622 | Dcps | Social Worker | 5504 Trout Run Rd, Clinton, MD 20735 | 2013-10-30 |
| 1902232614 | Rafael Antonio Acosta | Dentist | 7905 Malcolm Rd Ste 300, Clinton, MD 20735 | 2013-09-25 |
| 1407135874 | Richelle Wilson Harvey | Occupational Therapist | 8202 Shackelford Way, Clinton, MD 20735 | 2011-08-16 |
| Find all providers in zip 20735 | ||||
| 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 |
|---|---|---|---|---|
| 1700419041 | Alexander Sorokin Flecker | Physician Assistant | 200b Eager St, Clinton, MS 39056-4545 | 2020-02-14 |
| 1477190668 | Kimberly Mcraney Watson | Physician Assistant | 907 Oakhill Cir, Clinton, MS 39056-3743 | 2019-12-06 |
| 1649630229 | Elizabeth Atuya | Physician Assistant | 9135 Piscataway Rd Ste 102, Clinton, MD 20735-2548 | 2016-02-25 |
| 1780994376 | Karika Partilia Watkins-hill | Physician Assistant | 1515 Sunset Ave, Clinton, NC 28328-3827 | 2010-10-15 |
| 1184860827 | George L Carter | Physician Assistant | 10215 Deep Creek Ct, Clinton, MD 20735-5833 | 2008-12-31 |
| 1356471767 | Ann Rebecca Bartholomew | Physician Assistant | 1407 N 2000 W Ste G, Clinton, UT 84015-8563 | 2007-03-06 |
| 1598827172 | Akosua Flora Amankwah Wright | Physician Assistant | 7501 Surratts Rd Ste 303, Clinton, MD 20735-3377 | 2006-12-13 |
| 1356447882 | Mark Goodrich | Physician Assistant | 1477 North 2000 West, Westside Medical, Clinton, UT 84015 | 2006-09-15 |
| 1467556787 | Melanie Decock Wilson | Physician Assistant | 2900 S 25th St Ste B2, Clinton, IA 52732-7250 | 2006-09-08 |
| 1740206630 | Kolleen Marchand | Physician Assistant | 1477 N 2000 W, Clinton, UT 84015-8638 | 2006-07-14 |
| Find all providers in CLINTON | ||||
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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.