MR. PAUL DAVID BLAKELEY (NPI# 1104997907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104997907 |
Entity Type | Individual |
Full Name | MR. PAUL DAVID BLAKELEY |
Credential | CPO FAAOP |
Practice Address |
102 Willow Lane Spartanburg SC 29307-1343 |
Practice Telephone | 8645824411 |
Practice Fax Number | 8645736717 |
Mailing Telephone | 8645824411 |
Mailing Fax Number | 8645736717 |
Enumeration Date | 2006-11-13 |
Last Update Date | 2007-07-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 222Z00000X | Orthotist | SC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
X | 224P00000X | Prosthetist | SC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | 7701424 | 05 | |
SC | DME285 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407946478 | Paul R Blakeley | Nurse Anesthetist, Certified Registered | 9500 Euclid Ave, Cleveland, OH 44195-0001 | 2006-10-13 |
Street Address |
102 WILLOW LANE |
City | SPARTANBURG |
State | SC |
Zip Code | 29307-1343 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023677945 | Healogics Specialty Physicians of South Carolina, LLC | Clinic/Center | 1630 Skylyn Drive, Suite 420, Spartanburg, SC 29307 | 2019-06-13 |
1194247528 | Tawnia Lee Prince | Occupational Therapy Assistant | 110 Summit Knoll Drive, Spartanburg, SC 29307 | 2017-07-07 |
1730633553 | Laura K Taylor | Chiropractor | 1802 Drayton Road, Suite 309, Spartanburg, SC 29307 | 2016-08-10 |
1013372390 | Erin Lavette Farr | Nurse Practitioner | 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 | 2015-12-30 |
1316312010 | Joy Rogers | Speech-Language Pathologist | 175 Burdette St, Spartanburg, SC 29307 | 2015-12-07 |
1376923169 | Olivia Conrad | Speech-Language Pathologist | 220 Sloans Grove Rd, Spartanburg, SC 29307 | 2015-06-05 |
1457755118 | Optimal Radiology Partners of Virginia, Pllc | Radiology | 75 Skylyn Drive, Spartanburg, SC 29307 | 2014-10-09 |
1295033272 | Sean Quinn | Pharmacist | 790 East Main Street, Spartanburg, SC 29307 | 2011-03-01 |
1417250887 | James Edward Bradof | Internal Medicine | 212 Cypress Creek Drive, Spartanburg, SC 29307 | 2010-12-07 |
1528388030 | Tanya Tocharoen Tang | Internal Medicine | 126 Dillon Dr., Spartanburg, SC 29307 | 2010-06-07 |
Find all providers in zip 29307 |
Taxonomy Code | 222Z00000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Orthotist |
A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |
Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891236949 | Ian Alerre | Orthotist | 280 Dillon Cir, Spartanburg, SC 29307-1030 | 2017-03-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093287138 | Jonathan Daniel Whitten | Orthotist | 103 Clair Dr Ste B, Piedmont, SC 29673-6401 | 2018-12-31 |
1386164861 | Palmetto Biotech Prosthetics & Orthotics LLC | Orthotist | 1324 Calhoun St, Columbia, SC 29201-2512 | 2017-06-26 |
1053655530 | Bradley Clay Hornick | Orthotist | 931 Medical Cir, Myrtle Beach, SC 29572-4122 | 2012-11-21 |
1932409505 | Robert Allan Day | Orthotist | 2100 Old Highway 17 N Ste 102, North Myrtle Beach, SC 29582-2242 | 2010-10-28 |
1275766917 | Benjamin R Tigner | Orthotist | 6473 Chadwell Ct, Fort Mill, SC 29707-5840 | 2009-08-28 |
1861629446 | Kent Joseph Wiggins | Orthotist | 2210 Mossy Oaks Rd, Port Royal, SC 29935-1046 | 2009-06-22 |
1518581222 | Biologic P and O, LLC | Orthotist | 230 Elliott St, Orangeburg, SC 29115-6022 | 2020-05-29 |
1639708571 | Rebecca Bradleigh Leland | Orthotist | 3250 Harden Street Ext Ste 200, Columbia, SC 29203-6842 | 2020-04-03 |
1134765167 | Brenda Lee Sorrells | Orthotist | 223 S Herlong Ave Ste 110, Rock Hill, SC 29732-1089 | 2019-11-25 |
1043867054 | Au Medical Associates Inc | Orthotist | 901 Magnolia Dr, Aiken, SC 29803-7309 | 2019-08-23 |
Find all providers with the same taxonomy |
City | SPARTANBURG |
Zip Code | 29307 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.