NPI 1598062879 · live from the CMS NPI Registry
Chad Elvis Blankenship, PA-C
Physician Assistant in Concord, NC. National Provider Identifier 1598062879, active.
NPI record
| NPI | 1598062879 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 284 Executive Park Dr Ste 100, Concord, NC 28025 |
| Practice phone | 704-939-1100 |
| Mailing address | 1333 Southview Dr, Bluefield, WV 24701 |
| Enumerated | February 22, 2011 |
| Last updated | November 27, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 0010-02659 (NC) |
| Physician Assistant primary | 363A00000X | 1872 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.