Individual provider Active NPI

Sylva Ladawn Blackburn

  • Personal Care Attendant
  • Fort Gay, WV
National Provider Identifier
1043825433
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Practice address
274 Laura Fork Rd
Fort Gay, WV 25514-8020
Phone
(304) 648-7059
NPI assigned
Sep 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Primary

Addresses

Primary practice location

274 Laura Fork Rd
Fort Gay, WV 25514-8020

Mailing address

274 Laura Fork Rd
Fort Gay, WV 25514-8020
Phone (304) 648-7059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1043825433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 LAURA FORK RD",
            "city": "FORT GAY",
            "state": "WV",
            "postal_code": "255148020",
            "telephone_number": "304-648-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 LAURA FORK RD",
            "city": "FORT GAY",
            "state": "WV",
            "postal_code": "255148020",
            "telephone_number": "304-648-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "SYLVA",
        "middle_name": "LADAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gay, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.