TABULA RASA PLLC NPI 1407396773

NPI Information

  • NPI: 1407396773
  • Provider Name: TABULA RASA, PLLC
  • Classification: Preferred Provider Organization - 305R00000X
  • Entity Type: Organization
  • Address: 1296 ROBERT C. BYRD DRIVE
    CRAB ORCHARD, WV
    ZIP 25827
  • Phone: (681) 238-5957

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NPI Details

TABULA RASA, PLLC is a preferred provider organization in Crab Orchard, WV. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. TABULA RASA, PLLC NPI is 1407396773. The provider is registered as an organization entity type.

The provider's business location address is:

1296 ROBERT C. BYRD DRIVE
CRAB ORCHARD, WV
ZIP 25827
Phone: (681) 238-5957
Fax: (681) 238-5958

The provider's authorized official is Kevin Blankenship .
The authorized official title is Owner and has the following contact phone number (681) 238-5957.

The enumeration date for this NPI number is 3/6/2017 and was last updated on 3/6/2017.

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
1305R00000XPreferred Provider Organization19121WEST VIRGINIAYes

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: 11/21/2025

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