MR. JOHN STEPHEN BLACKBURN (NPI# 1164490801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164490801 |
| Entity Type | Individual |
| Full Name | MR. JOHN STEPHEN BLACKBURN |
| Credential | CRNA |
| Practice Address |
7210g Broad River Rd Irmo SC 29063-7972 |
| Mailing Address |
Po Box 1637 Irmo SC 29063-1637 |
| Practice Telephone | 8034075266 |
| Mailing Telephone | 8034075266 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 11770 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | RN | 60552 | 01 |
| TN | APN | 11770 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700417490 | John Donald Blackburn II | Specialist/Technologist | 1995 Thunder Rd, Eagle Lake, FL 33839-3086 | 2020-01-31 |
| 1396741575 | John Roberts Blackburn | Urology | 719 W Coke Rd, Ste 2, Winnsboro, TX 75494-3060 | 2005-06-22 |
| 1841511037 | John W Blackburn | Anesthesiology | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2010-06-22 |
| 1215168604 | John C Blackburn | Counselor | 3130 N Dixie Hwy, Troy, OH 45373-1337 | 2009-08-03 |
| 1891970901 | John D. Blackburn | Physical Therapist | 500 Porter Ave, Aurora, MO 65605-2365 | 2008-01-08 |
| 1093777864 | John Devin Blackburn | Optometrist | 7409 N Cedar Ave, #103, Fresno, CA 93720-3836 | 2006-04-05 |
| Street Address |
7210G BROAD RIVER RD |
| City | IRMO |
| State | SC |
| Zip Code | 29063-7972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477501708 | Golden Rule Medical Services, Inc | Nurse Anesthetist, Certified Registered | 7210g Broad River Rd, Irmo, SC 29063-7972 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720603640 | Daniel Witcher | Counselor | 1180 Columbia Avenue, Suite 203, Irmo, SC 29063 | 2020-06-16 |
| 1710512140 | Arie Anew Services Incorporated | Psychologist | 7803 St. Andrews Road, C5, Irmo, SC 29063 | 2020-03-05 |
| 1366922296 | Jennie C Beym | Speech-Language Pathologist | 7 Tip Top Court, Irmo, SC 29063 | 2018-08-20 |
| 1295214088 | The Well LLC | Massage Therapist | 1720 Dutch Fork Rd., Irmo, SC 29063 | 2018-08-13 |
| 1699268821 | Shannon Marie Kelly | Dentist | 200 N Royal Tower Dr, Irmo, SC 29063 | 2018-06-12 |
| 1497243174 | Anthony Batiste Thompson Jr. | Behavior Technician | 137 Chapelwhite Road, Irmo, SC 29063 | 2018-04-27 |
| 1578076022 | Demario Sawyer Sr | Ambulance | 107 N Royal Tower Dr Ste C, Irmo, SC 29063 | 2017-11-07 |
| 1306365713 | Dreher Shuler | Student in an Organized Health Care Education/Training Program | 205 River Creek Drive, Irmo, SC 29063 | 2017-09-18 |
| 1053833442 | Tania Rodriguez | Social Worker | 30 Ash Court, Irmo, SC 29063 | 2017-07-07 |
| 1598294944 | Ashley Elaine Bradley | Home Health | 120 Stockland Rd, Irmo, SC 29063 | 2017-06-08 |
| Find all providers in zip 29063 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043274483 | Sharon K. Harmon | Nurse Anesthetist, Certified Registered | 1 Wellness Blvd, Suite 110, Irmo, SC 29063-2871 | 2006-04-13 |
| 1164830428 | J&j Anesthesia, LLC | Nurse Anesthetist, Certified Registered | 1 Wellness Blvd, Suite 110, Irmo, SC 29063-2871 | 2014-07-30 |
| 1477501708 | Golden Rule Medical Services, Inc | Nurse Anesthetist, Certified Registered | 7210g Broad River Rd, Irmo, SC 29063-7972 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063905867 | Kelsey Squires Lennon | Nurse Anesthetist, Certified Registered | 101 Reedy View Dr Apt 174, Greenville, SC 29601-1827 | 2018-06-07 |
| 1164914552 | Amanda R Dipiazza | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr Ste E, Charleston, SC 29406 | 2018-06-01 |
| 1710480280 | Midlands Anesthesia Company, LLC | Nurse Anesthetist, Certified Registered | 340 Sumter Hwy, Camden, SC 29020-9347 | 2018-03-12 |
| 1386155265 | Ajith A Skariah | Nurse Anesthetist, Certified Registered | 311 Chartwell Dr, Greer, SC 29650-4784 | 2017-10-18 |
| 1447616917 | Teletha Ruth | Nurse Anesthetist, Certified Registered | 42 Oak St, Varnville, SC 29944-4855 | 2016-01-13 |
| 1508221037 | Polaya Anesthesia LLC | Nurse Anesthetist, Certified Registered | 201 74th Ave N, Myrtle Beach, SC 29572-3832 | 2015-12-29 |
| 1255702007 | Jane Elizabeth Donnan | Nurse Anesthetist, Certified Registered | 1313 E North St, Greenville, SC 29607-1355 | 2015-10-19 |
| 1285010611 | Terra Lynn Kloth | Nurse Anesthetist, Certified Registered | 6451 Come About Way, Awendaw, SC 29429-6022 | 2015-08-07 |
| 1306226402 | Shayla Callahan | Nurse Anesthetist, Certified Registered | 1412 Red Sunset Ln, Blythewood, SC 29016-7639 | 2015-06-03 |
| 1295120822 | Lisa G James | Nurse Anesthetist, Certified Registered | 2 Chestnut Hill Pl, Simpsonville, SC 29680-6662 | 2015-03-31 |
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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.