MR. BROCK BLANKENSHIP (AA-C) – Anesthesiologist Assistant, NPI 1154679744

MR. BROCK BLANKENSHIP (AA-C) is a healthcare provider. based in Albany, Georgia. specializing in ANESTHESIOLOGY ASSISTANT. They hold the professional credentials AA-C. They hold a License No. AA395 (FL). The NPI Number for MR. BROCK BLANKENSHIP (AA-C) is 1154679744

Main info

Male
19 Years Of Experience
Accepts Medicare Assignment
Name
MR. BROCK BLANKENSHIP (AA-C)
NPI
1154679744
Phone
(229) 312-1000
Address
417 Third Ave
Enumeration Date
29 August 2012
Last Update Date
8 September 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9549395000
Graduation Year
2007 (19 years ago)
PAC ID
4789834730
Group Practice PAC ID
7416869565
Professional Enrollment ID
I20171031000261
Address ID
FL322161431JA4201XRDXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

1,383 ANESTHESIOLOGY ASSISTANT in GA

Provider Addresses for MR. BROCK BLANKENSHIP (AA-C)

  • 417 Third Ave

    Albany, GA 31701

    Phone: (229) 312-1000

    Type: Location

  • 1301 RIVERPLACE BLVD STE 2540

    JACKSONVILLE, FL 322079032

    Phone: (352) 284-4805

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-10-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20171031000261IAnesthesiology AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
01402Anesthesia for procedure for total knee joint replacement3535$0
01214Anesthesia for total hip replacement2424$0
View full utilization report →

Insurance plans in this area (ZIP 31701)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416869565View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)FL
A N E S T H E S I O L O G YFL
-WI
A N E S T H E S I O L O G YFL
-FL
-FL
A N E S T H E S I O L O G YFL
-FL
Certified Registered Nurse Anesthetist (Crna)FL
A N E S T H E S I O L O G YPA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do payers reference MR. BROCK BLANKENSHIP (AA-C)?
For MR. BROCK BLANKENSHIP (AA-C), use NPI 1154679744 as the unique 10-digit identifier.
Is MR. BROCK BLANKENSHIP (AA-C) still an active registrant?
MR. BROCK BLANKENSHIP (AA-C) carries an active NPI according to the public dataset.
What area of care is associated with MR. BROCK BLANKENSHIP (AA-C)?
MR. BROCK BLANKENSHIP (AA-C)'s record emphasizes Anesthesiologist Assistant. Clinical services aligned with this taxonomy classification.
Is MR. BROCK BLANKENSHIP (AA-C) located near Albany?
MR. BROCK BLANKENSHIP (AA-C) currently maps to Albany, Georgia in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

Similar Providers

MR. RICHARD BRACKEN (AA-C)

Anesthesiologist Assistant
Phoebe Putney Memorial Hospital North Campus, 2000, Palmyra Road, Albany, Dougherty County, Georgia, 31701, United States
NPI: 1316938939

BRITT A BOONE (PA)

Anesthesiologist Assistant
Phoebe Putney Memorial Hospital, 417, 3rd Avenue West, Albany, Dougherty County, Georgia, 31701, United States
NPI: 1861506511

BRITTON C SUBER (PA)

Anesthesiologist Assistant
Phoebe Putney Memorial Hospital, 417, West 3rd Avenue, Albany, Dougherty County, Georgia, 31701, United States
NPI: 1962516567

WILILAM HENRY II BUNTIN (PA)

Anesthesiologist Assistant
Phoebe Putney Memorial Hospital, 417, 3rd Avenue West, Albany, Dougherty County, Georgia, 31701, United States
NPI: 1528172137

DEREK BRIAN WALKER

Anesthesiologist Assistant
2766 OLD OCILLA ROAD
NPI: 1982916532

CHRISTINIA M BAKER (PA)

Anesthesiologist Assistant
417 W 3RD AVE
NPI: 1093025991

CATHERINE H SAUNDERS (PA)

Anesthesiologist Assistant
500 W 3RD AVE
NPI: 1164732939

LEIGH E WENSLOW (PAA)

Anesthesiologist Assistant
417 W 3RD AVE
NPI: 1053691386

MR. RAYON DOSETHAREH (AA-C)

Anesthesiologist Assistant
413 W 3RD AVE
NPI: 1669720843