LUKE JOHNATHAN BLANKENHEIM PA-C NPI 1174829774

NPI Information

  • NPI: 1174829774
  • Provider Name: LUKE JOHNATHAN BLANKENHEIM, PA-C
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 8926 WOODYARD RD
    SUITE 701
    CLINTON, MD
    ZIP 20735
  • Phone: (301) 856-1682

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NPI Details

Luke Johnathan Blankenheim, PA-C is a physician assistant in Clinton, MD. The provider is 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. Luke Johnathan Blankenheim, PA-C NPI is 1174829774. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8926 WOODYARD RD
SUITE 701
CLINTON, MD
ZIP 20735-220
Phone: (301) 856-1682
Fax: (301) 856-8214

The NPI 1174829774 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 1/31/2011 and was last updated on 2/13/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantC0004416MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00992732OTHERRAILROAD MEDICARE INDIVIDUAL PTAN
2233114YZWMEDICARE PIN
3217882ZAKWMEDICARE PIN
4CI2264OTHERRAILROAD MEDICARE GROUP PTAN
5C0004416OTHERMARYLAND LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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