SALLY S BLAKE (NPI# 1750432985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750432985 |
| Entity Type | Individual |
| Full Name | SALLY S BLAKE |
| Credential | FNP-C |
| Practice Address |
2319 Saint Matthews Rd Orangeburg SC 29118 |
| Mailing Address |
2319 Saint Matthews Rd Orangeburg SC 29118-2042 |
| Practice Telephone | 8035361571 |
| Practice Fax Number | 8035343860 |
| Mailing Telephone | 8035361571 |
| Mailing Fax Number | 8035343860 |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2019-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
710 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | PRESCRIPTIVE AUTHORITY | F710 | 01 |
| SC | STATE LICENSE # | 710 | 01 |
| SC | NP1060 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 521 Gibson Rd, Lexington, SC 290722551 | 8039513490 | 8039513557 |
| 86 Wren St, Barnwell, SC 298121529 | 8032595762 | 8032593250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407364896 | Sally Blake | Social Worker | 2500 Overlook Ter, Madison, WI 53705-2254 | 2018-01-19 |
| Street Address |
2319 SAINT MATTHEWS RD |
| City | ORANGEBURG |
| State | SC |
| Zip Code | 29118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619966843 | Diane Bell | Counselor | 2319 Saint Matthews Rd, Orangeburg, SC 29118-2042 | 2005-10-20 |
| 1982229464 | Keisha Sharie Yarborough | Nurse Practitioner | 2319 Saint Matthews Rd, Orangeburg, SC 29118-2042 | 2020-06-10 |
| 1760016208 | Morris Lewis Thompson | Counselor | 2319 Saint Matthews Rd, Orangeburg, SC 29118-2042 | 2020-02-24 |
| 1992338537 | Karyney T Mcmillan | Counselor | 2319 Saint Matthews Rd, Orangeburg, SC 29118-2042 | 2020-02-21 |
| 1952934697 | Jessica Marie Davis | Counselor | 2319 Saint Matthews Rd, Orangeburg, SC 29118-2042 | 2020-02-21 |
| 1154968303 | Touray K Beaton Jr. | Counselor | 2319 Saint Matthews Rd, Orangeburg, SC 29118-2042 | 2019-12-06 |
| 1871138206 | Elaine Hamilton Kelly | Counselor | 2319 Saint Matthews Rd, Orangeburg, SC 29118-2042 | 2019-11-08 |
| 1760024772 | Charlene Simmons | Counselor | 2319 Saint Matthews Rd, Orangeburg, SC 29118-2042 | 2019-10-10 |
| 1841759487 | Ashley E Keys | Counselor | 2319 Saint Matthews Rd, Orangeburg, SC 29118-2042 | 2019-03-13 |
| 1356808372 | Sandra Clark | Counselor | 2319 Saint Matthews Rd, Orangeburg, SC 29118-2042 | 2019-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386268175 | Sharon Y Tremble | Speech-Language Pathologist | 222 Summit Parkway, Orangeburg, SC 29118 | 2020-06-08 |
| 1922658756 | Orangeburg County School District | Local Education Agency (LEA) | 102 Founders Court, Orangeburg, SC 29118 | 2019-09-13 |
| 1710442967 | Central Carolina Endodontics Pa | Dentist | 888 Cook Road, Orangeburg, SC 29118 | 2019-02-01 |
| 1821572009 | Sharon Fogle | Counselor | 2319 Wt. Matthews Road, Orangeburg, SC 29118 | 2018-09-24 |
| 1104320001 | South Carolina Surgical Pa | Surgery | 3045 St Matthews Road, Orangeburg, SC 29118 | 2018-03-23 |
| 1477056794 | Palmetto Moon Anesthesia, LLC | Anesthesiology | 3045 St. Matthews Rd., Orangeburg, SC 29118 | 2018-03-13 |
| 1730691882 | Bio-medical Applications of South Carolina, Inc. | Clinic/Center | 125 Kinard St, Orangeburg, SC 29118 | 2017-10-30 |
| 1154862746 | Latasha Hott | Nurse Practitioner | 2323 St. Matthews Rd, Orangeburg, SC 29118 | 2017-03-15 |
| 1154786960 | R Dale Padgett Md Pa | Clinic/Center | 1727 Villagepark Dr, Orangeburg, SC 29118 | 2015-12-21 |
| 1881977726 | Ontime Transport LLC | Non-emergency Medical Transport (VAN) | 2851 Pelham Ct, Orangeburg, SC 29118 | 2011-09-27 |
| Find all providers in zip 29118 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023635935 | Chinise Kayanna Clinton | Nurse Practitioner | 2310 Magnolia St, Orangeburg, SC 29115-3731 | 2020-06-26 |
| 1245742774 | Stacy Jill Hoover | Nurse Practitioner | 1995 Saint Matthews Rd, Orangeburg, SC 29118-2405 | 2017-10-24 |
| 1104211234 | Sheryl Durant Singleton | Nurse Practitioner | 1857 Joe S Jeffords Hwy, Orangeburg, SC 29115 | 2015-04-06 |
| 1598894214 | Janet C Russo | Nurse Practitioner | 6 Kingswood Dr, Orangeburg, NY 10962-1806 | 2007-03-06 |
| 1558389502 | Julia A Hobson | Nurse Practitioner | 3310 Magnolia Street, Orangeburg, SC 29115-1468 | 2006-07-18 |
| 1508882184 | Colleen Marcia Kilgore | Nurse Practitioner | 1620 Broughton St, Orangeburg, SC 29115-4867 | 2006-07-15 |
| 1285650515 | Lynn E Glenn | Nurse Practitioner | 141 Centre Street, Orangeburg, SC 29115 | 2006-07-13 |
| 1689678310 | Vicki Clinton Green | Nurse Practitioner | 1550 Carolina Ave, Orangeburg, SC 29115-4944 | 2005-06-10 |
| 1619504248 | Tamara Till | Nurse Practitioner | 1324 Grove Park Dr, Orangeburg, SC 29115-2455 | 2020-03-24 |
| 1134778699 | Emilee Robin Bartley | Nurse Practitioner | 1161 Cook Rd, Orangeburg, SC 29118-8204 | 2019-09-08 |
| Find all providers in ORANGEBURG | ||||
| City | ORANGEBURG |
| Zip Code | 29118 |
Please comment or provide details below to improve the information on SALLY S BLAKE.
| 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.