Corey Blagsvedt, RBT

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

17-38371 Issued in SC

Practice address

2413 Savannah Hwy
Charleston, SC 29414-5323

Phone

(843) 449-0554

NPI assigned

Jul 16, 2021

Last updated

Jul 16, 2021By the provider in NPPES

Sex

Male

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

Electronic endpoints 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sos Health Care Inc

  • Behavior Analyst
  • Surfside Beach, SC
  • NPI 1235664673
  NPD (past)

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1356913438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 AZALEA DR, MYRTLE BEACH",
            "city": "MYRTLE BEACH, SC",
            "state": "SC",
            "postal_code": "29575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2413 SAVANNAH HWY",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145323",
            "telephone_number": "843-449-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAGSVEDT",
        "first_name": "COREY",
        "credential": "RBT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-16",
        "last_updated": "2021-07-16",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "SC",
            "license": "17-38371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cblagsvedt@soscaresc.org",
            "affiliation": "N",
            "address_1": "34 Cedarhurst Ave",
            "city": "Charleston",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294073842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Trevor Lynn Blackstock, MD
• Shannon Blackstone
• Russell Steven Blackwelder, M.D. , M.DIV.
• Sarah Grace Blackwell, RBT
• April Pineda Favela Blackwood, MD
• Brittany Schrader Blain, PHARMD
• Christy M Blair, APRN
• Jessica Murner Blair, DNP, APRN, FNP-BC
• Julie Ane Blair, MA CCC-SLP
• Tracy Lynn Blair, CRNA

• Behavior Analyst in Charleston, SC
• Providers in Charleston, SC by specialty
• Behavior Analyst in South Carolina

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