Active NPI
Healing Hydration
- Family Nurse Practitioner
- Clayton, NC
National Provider Identifier
1215760384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- HEALING HYDRATION
- Practice address
- 620 NC Highway 42 W Ste 207
Clayton, NC 27520-5803 - Phone
- (910) 514-2775
- NPI assigned
- Aug 23, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sherlene Elane Blackwood, FNP-C
- Title
- Co-Founder, FNP
- Phone
- (910) 514-2775
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
620 NC Highway 42 W Ste 207
Clayton, NC 27520-5803
Mailing address
620 NC Highway 42 W Ste 207
Clayton, NC 27520-5803
Phone (910) 514-2775
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724371200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724371200000",
"number": "1215760384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 NC HIGHWAY 42 W STE 207",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275205803",
"telephone_number": "910-514-2775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 NC HIGHWAY 42 W STE 207",
"city": "CLAYTON",
"state": "NC",
"postal_code": "275205803",
"telephone_number": "910-514-2775"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALING HYDRATION",
"organizational_subpart": "NO",
"enumeration_date": "2024-08-23",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A",
"authorized_official_last_name": "BLACKWOOD",
"authorized_official_first_name": "SHERLENE",
"authorized_official_middle_name": "ELANE",
"authorized_official_title_or_position": "CO-FOUNDER, FNP",
"authorized_official_telephone_number": "910-514-2775",
"authorized_official_credential": "FNP-C"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clayton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.