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MR. BROCK BLANKENSHIP AA-C
NPI 1154679744
Anesthesiologist Assistant in Jacksonville, FL

Active since August 29, 2012Accepts Medicare Assignment
1301 RIVERPLACE BLVD STE 2540, JACKSONVILLE, FL 32207(352) 284-4805 Get Directions Write a Review

NPPES record last updated: September 8, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Brock Blankenship Aa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BROCK BLANKENSHIP AA-C (NPI 1154679744) is an individual anesthesiologist assistant in Jacksonville, Florida, licensed in Florida (AA395) and active in the NPI registry since August 2012. He is affiliated with Ascension St Vincent's Southside, maintains a secondary practice location in Albany, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1154679744
Entity TypeIndividualMale
Primary Taxonomy367H00000X
Provider Legal NameMR. BROCK BLANKENSHIPCredential: AA-C
Location Address1301 RIVERPLACE BLVD STE 2540Jacksonville, FL 32207-9032
Mailing Address1301 Riverplace Blvd Ste 2540Jacksonville, FL 32207-9032 · (352) 284-4805
Phone(352) 284-4805
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateAugust 29, 2012
Last NPPES UpdateSeptember 8, 2020
NPPES CertifiedSeptember 8, 2020
✔ NPI 1154679744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367H00000X
License✔ Licensed in FL · AA395
Definition
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.
1301 RIVERPLACE BLVD STE 2540, Jacksonville, FL 32207
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Secondary Practice Location 1

Location 1417 Third AveAlbany, GA 31701 · Phone (229) 312-1000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Brock Blankenship Aa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789834730
PECOS Enrollment IDI20171031000261

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Anesthesia for procedure for total knee joint replacement 01402
Anesthesia for a total knee joint replacement numbs your body to eliminate pain during surgery. This could be general anesthesia where you're unconscious, or regional anesthesia where only the leg is numb. It's administered by a specialist, ensuring safety and comfort.
28 services28 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension St Vincent's Southside

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100307
Location4201 Belfort RdJacksonville, FL 32216 · Duval County
Emergency services Birthing friendly

Ascension St Vincent's St Johns County

Acute Care Hospitals · St Johns, FL
OwnershipVoluntary non-profit - Private
CMS Certification Number100361
Location205 Trinity WaySt Johns, FL 32259 · St. Johns County
Emergency services

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE CAROLINE BAREFOOT MD
Anesthesiology
1301 RIVERPLACE BLVD STE 2540
JACKSONVILLE, FL 32207
Duval County (904) 788-7449
DR. JACOB MARSHALL GILLIKIN MD, MPH
Anesthesiology
1301 RIVERPLACE BLVD STE 2540
JACKSONVILLE, FL 32207
Duval County (904) 387-4030
CELENA CARR MSN
Nurse Anesthetist, Certified Registered
1301 RIVERPLACE BLVD STE 2540
JACKSONVILLE, FL 32207
Duval County (904) 387-4030

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brock Blankenship's NPI number?

The NPI number for Brock Blankenship is 1154679744. It was assigned to this individual provider in the NPPES registry on August 29, 2012.

Where is Brock Blankenship located?

Brock Blankenship practices at 1301 Riverplace Blvd Ste 2540, Jacksonville, FL 32207. The listed phone number is (352) 284-4805.

What is Brock Blankenship's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Brock Blankenship enrolled in Medicare?

Yes. Brock Blankenship is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Brock Blankenship affiliated with any hospitals?

According to CMS data, Brock Blankenship is affiliated with Ascension St Vincent's Southside and Ascension St Vincent's St Johns County.

When was this NPI record last updated?

The NPPES record for Brock Blankenship was last updated on September 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.