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DEREK BLANKENSHIP PA-C
NPI 1194106690
Physician Assistant in Jackson, TN

Active since June 10, 2015PECOS Enrolled
620 SKYLINE DR, JACKSON, TN 38301(731) 541-6180 Get Directions Write a Review

NPPES record last updated: October 5, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Derek Blankenship Pa-c NPPES

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

DEREK BLANKENSHIP PA-C (NPI 1194106690) is an individual physician assistant in Jackson, Tennessee, licensed in Tennessee (2793) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194106690
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDEREK BLANKENSHIPCredential: PA-C
Location Address620 SKYLINE DRJackson, TN 38301-3923
Mailing Address620 Skyline DrJackson, TN 38301-3923
Phone(731) 541-6180
Sole ProprietorNo
Enumeration DateJune 10, 2015
Last NPPES UpdateOctober 5, 2015
✔ NPI 1194106690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TN · 2793
Definition
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.
620 SKYLINE DR, Jackson, TN 38301
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derek Blankenship Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$66.01 typical visit price
range $16.72 – $131.41
Typical copayment $16.50 (range $4.18 – $32.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

ASHLEY BROOKE OLDHAM PORTER M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
620 SKYLINE DR
JACKSON, TN 38301
Madison County (731) 541-6026
ADAM BOYD VAUGHN
Anesthesiology (Critical Care Medicine)
620 SKYLINE DR
JACKSON, TN 38301
Madison County (731) 541-5000
MS. JOHNETTA NEWSON OT
Occupational Therapist
620 SKYLINE DR
JACKSON, TN 38301
Madison County (731) 541-5000
MORGAN JANAE MASON
Physician Assistant
620 SKYLINE DR
JACKSON, TN 38301
Madison County (731) 541-5000
LYDIA BUTTS PHARMD
Pharmacist
620 SKYLINE DR
JACKSON, TN 38301
Madison County (731) 541-9295
DR. WILLIAM TYLER HAYDEN M.D.
Emergency Medicine
620 SKYLINE DR
JACKSON, TN 38301
Madison County (731) 343-0886
COURTNEY BRUSH APRN, FNP
Nurse Practitioner (Family)
620 SKYLINE DR
JACKSON, TN 38301
Madison County (731) 541-6900
BRENDAN MCKINNEY
Nurse Anesthetist, Certified Registered
620 SKYLINE DR
JACKSON, TN 38301
Madison County (731) 541-7070

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 Derek Blankenship's NPI number?

The NPI number for Derek Blankenship is 1194106690. It was assigned to this individual provider in the NPPES registry on June 10, 2015.

Where is Derek Blankenship located?

Derek Blankenship practices at 620 Skyline Dr, Jackson, TN 38301. The listed phone number is (731) 541-6180.

What is Derek Blankenship's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Derek Blankenship enrolled in Medicare?

Yes. Derek Blankenship is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Derek Blankenship was last updated on October 5, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.