MEGAN KATHERINE BLANKENSHIP FNP
NPI 1366969834
Nurse Practitioner - Family in Durham, NC
NPI Status: Active since August 25, 2017
Contact Information
2511 OLD CORNWALLIS RD STE 200
DURHAM, NC
ZIP 27713
Phone: (919) 932-5700
Fax: (919) 933-6881
- Individual
- Female
- Years of Experience 9
- Nurse Practitioner
- Family
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
- Medicare Quality Reporting
About MEGAN BLANKENSHIP
This page provides the complete NPI Profile along with additional information for Megan Blankenship, a provider established in Durham, North Carolina with a medical specialization in Nurse Practitioner, focusing in family and more than 9 years of experience. The healthcare provider is registered in the NPI registry with number 1366969834 assigned on August 2017. The practitioner's primary taxonomy code is 363LF0000X with license number 5009811 (NC). The provider is registered as an individual and her NPI record was last updated 3 years ago.
- NPI
- 1366969834
- Provider Name
- MEGAN KATHERINE BLANKENSHIP FNP
- Other Name
- MEGAN BARHAM THOMAS FNP
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 2511 OLD CORNWALLIS RD STE 200 DURHAM, NC 27713
- Location Phone
- (919) 932-5700
- Location Fax
- (919) 933-6881
- Mailing Address
- 5708 CONCORD HWY MONROE, NC 28110
- Mailing Phone
- (704) 995-1496
- Medical School Name
- OTHER
- Graduation Year
- 2017
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-25-2017
- Last Update Date
- 02-23-2023
- Code Navigator
A nurse practitioner (NP) like Megan Blankenship is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 5009811
- License State
- NC
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Gold - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Bronze with Atrium Health - HMO
- Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
- Focused Silver with Atrium Health - HMO
- Focused Silver with Atrium Health + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze with Atrium Health - HMO
- Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard A | Nationwide Doctors - PPO
- Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
- Blue Care Bronze Complete | $60 PCP | $20 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Bronze HSA Eligible | Integrated | Statewide Doctors - HMO
- Blue Care Bronze Standard | Statewide Doctors - HMO
- Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Gold Standard A | Statewide Doctors - HMO
- Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors - HMO
- Blue Care Silver Standard | Statewide Doctors - HMO
- Blue Value Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Limited Statewide Doctors - POS
- Blue Value Bronze Complete | $60 PCP | $20 Tier 1 Rx | Limited Statewide Doctors - POS
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Standard+ Dental + Vision (No Referrals) - HMO
- UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
- UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
- UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
- UHC Silver Value ($0 Virtual Urgent Care, No Referrals) - HMO
- UHC Silver Value + ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Megan Blankenship is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Megan Blankenship is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 4880960970
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20171017002159
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Other DME (DE017N)
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips (HCPCS:A4253)
3 DME suppliers used 27 Medicare Claims 77 Services Paid
DME-Other DME (DE000N)
Normal, low and high calibrator solution / chips (HCPCS:A4256)
2 DME suppliers used 15 Medicare Claims 15 Services Paid
DME-Medical/Surgical Supplies (DA000N)
Lancets, per box of 100 (HCPCS:A4259)
3 DME suppliers used 13 Medicare Claims 18 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Wheelchairs (DD000N)
Standard wheelchair (HCPCS:K0001)
2 DME suppliers used 19 Medicare Claims 19 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient custodial care facility, group care, or assisted living visit, typically 1 hour
Established patient custodial care facility, group care, or assisted living visit, typically 40 minutes
New patient custodial care facility, group care, or assisted living visit, typically 1 hour
New patient custodial care facility, group care, or assisted living visit, typically 75 minutes
This service involves a healthcare professional visiting an established patient in a group care facility or assisted living for about an hour. The visit may include health checks, medication management, and addressing any health concerns to maintain the patient's well-being.
This service was performed 837 times for 143 patientsThis is a routine visit for established patients residing in care facilities like nursing homes or assisted living. The visit typically lasts about 40 minutes, during which the healthcare provider checks your overall health, discusses any concerns, and adjusts care plans as needed.
This service was performed 372 times for 117 patientsThis service involves a one-hour visit for a new patient at a custodial care facility, group care home, or assisted living facility. During this time, a healthcare professional will assess the patient's health condition, discuss care plans, and address any concerns the patient may have.
This service was performed 60 times for 60 patientsThis service involves an initial visit to a new patient in a custodial care facility, group care, or assisted living. The visit typically lasts 75 minutes and focuses on assessing the patient's health status, understanding their needs, and planning their ongoing care.
This service was performed 15 times for 15 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.97 for a new patient copayment and $23.98 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 27713 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $83.9
- Minimum New Patient Price $54.12
- Maximum New Patient Price $165.09
- Average New Patient Copayment $20.97
- Minimum New Patient Copayment $13.53
- Maximum New Patient Copayment $41.27
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $95.94
- Minimum Established Patient Price $17.21
- Maximum Established Patient Price $134.61
- Average Established Patient Copayment $23.98
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.65
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Implementation of Integrated Patient Centered Behavioral Health Model | Yes | N/A |
| Offer integrated behavioral health services to support patients with behavioral health needs who also have conditions such as dementia or other poorly controlled chronic illnesses. The services could include one or more of the following: • Use evidence-based treatment protocols and treatment to goal where appropriate; • Use evidence-based screening and case finding strategies to identify individuals at risk and in need of services; • Ensure regular communication and coordinated workflows between MIPS eligible clinicians in primary care and behavioral health; • Conduct regular case reviews for at-risk or unstable patients and those who are not responding to treatment; • Use of a registry or health information technology functionality to support active care management and outreach to patients in treatment; • Integrate behavioral health and medical care plans and facilitate integration through co-location of services when feasible; and/or • Participate in the National Partnership to Improve Dementia Care Initiative, which promotes a multidimensional approach that includes public reporting, state-based coalitions, research, training, and revised surveyor guidance. | ||
| Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record | Yes | N/A |
| • Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management. | ||
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Megan Blankenship is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| CAROLINAS MEDICAL CENTER-NORTHEAST | 920 CHURCH ST N CONCORD, NC 28025 | (704) 783-3000 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1366969834, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 76. The final step is to find the difference between that total and the next multiple of ten (80 - 76 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 76 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
DURHAM, NC 27713
DURHAM, NC 27713
DURHAM, NC 27713
DURHAM, NC 27713
DURHAM, NC 27713
DURHAM, NC 27713
DURHAM, NC 27713
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366969834, enumerated as an "individual" on August 25, 2017.
The provider is located at 2511 OLD CORNWALLIS RD STE 200 DURHAM, NC 27713 and the phone number is (919) 932-5700.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.
Megan Blankenship is affiliated with: CAROLINAS MEDICAL CENTER-NORTHEAST.
