Active NPI
Elizabeth W. Blake, PHARMD
- Pharmacotherapy Pharmacist
- Columbia, SC
National Provider Identifier
1174512289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 10123
- Practice address
- 715 Sumter St
Room 314a
Columbia, SC 29208-0001 - Phone
- (803) 777-6058
- Fax
- (803) 777-1943
- NPI assigned
- Oct 20, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 10123 | SC | Primary |
Addresses
Primary practice location
715 Sumter St
Room 314a
Columbia, SC 29208-0001
Mailing address
156 Presque Isle Rd
Lexington, SC 29072-7746
Phone (803) 808-7227
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10123 | SC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174512289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "156 PRESQUE ISLE RD",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290727746",
"telephone_number": "803-808-7227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "715 SUMTER ST",
"address_2": "ROOM 314A",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292080001",
"telephone_number": "803-777-6058",
"fax_number": "803-777-1943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "ELIZABETH",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "SC",
"license": "10123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.