Sherry G Blackwood, MCD, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LA 2617 Issued in LA

Practice address

208 Sweetwater Rim
Pineville, LA 71360-5691

Phone

(318) 419-8176

NPI assigned

Sep 15, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hayes Healthcare Services

  • Occupational Therapist
  • Pineville, LA
  • NPI 1285790113

  Speech-Language Pathologist

  NPD (past)
• Hayes Healthcare Services

  • Pediatric Occupational Therapist
  • Pineville, LA
  • NPI 1821164062

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1295068781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4126 MARYLAND AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711061438",
            "telephone_number": "318-470-7600",
            "fax_number": "318-868-2468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 SWEETWATER RIM",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713605691",
            "telephone_number": "318-419-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWOOD",
        "first_name": "SHERRY",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "MCD, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "LA 2617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDAVANT",
            "identifier": "4600442",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manu Bhargava, M.D., F.A.A.P.
• Bio-Medical Applications of Louisiana, LLC
• Melinda Peal Bishop, MBA, RD
• Carolyn Christine Blackstone, GSW
• Tracey Hawthorne Blackwell, BSW., CIT
• Eric Shane Blair, M.S.
• Clara Bell Blake
• Brian W. Blakewood, CRNA
• Michelle Blose, PSYD
• Greg H Bolton, PA-C

• Speech-Language Pathologist in Pineville, LA
• Providers in Pineville, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.