Organization Active NPI

Healing Hydration

  • Family Nurse Practitioner
  • Clayton, NC
National Provider Identifier
1215760384
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
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

Updated by the provider on Aug 23, 2024

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)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Practitioners & 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.

Verify at the official NPI Registry.