Jean D Blackmon, RN

Primary specialty

Urology Registered NurseTaxonomy code 163WU0100X

License

104325 Issued in SC

Practice address

1551 Ben Sawyer Blvd Unit 5G
Mt Pleasant, SC 29464-5508

Phone

(843) 367-9938

NPI assigned

Mar 16, 2021

Last updated

Mar 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1205411766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 BEN SAWYER BLVD UNIT 5G",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294645508",
            "telephone_number": "843-367-9938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 BEN SAWYER BLVD UNIT 5G",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294645508",
            "telephone_number": "843-367-9938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "JEAN",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WU0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Urology",
            "state": "SC",
            "license": "104325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Birnie, P.T.
• Amanda Grace Bishop
• Megan Biwan, RN
• Elizabeth Jane Bjornson, DDS, MHS
• Joshua S. Black, M.D.
• Jonathan David Blackwell, PT PHYSICAL THERAPIS
• Terri Lynn Blackwell, PA-C
• Blair Hayes Co. LLC (Blair Hayes Ortho)
• Amy Blair
• Christine Roebuck Blake, OTR L CHT

• Registered Nurse in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.