Cheryl Marie Blakely, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

272711-1 Issued in NY

Practice address

8472 State Route 20
Waterville, NY 13480-2416

Phone

(315) 749-8822

NPI assigned

Oct 23, 2019

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 23, 2019.

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1407499288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8472 STATE ROUTE 20",
            "city": "WATERVILLE",
            "state": "NY",
            "postal_code": "134802416",
            "telephone_number": "315-749-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8472 STATE ROUTE 20",
            "city": "WATERVILLE",
            "state": "NY",
            "postal_code": "134802416",
            "telephone_number": "315-749-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "CHERYL",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "272711-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianne Taylor Barnes
• Bartholomew Chiropractic PC
• Jeremy L Bartholomew, D.C.
• Heather Mosher Bauer, D.V.M.
• Dionne Denise Beach, PT, DPT
• Svetlana Bykovich, NP
• Michael D Cash, PT
• Francis E Chabot, MD
• Chapman Chiropractic, PLLC
• Community Memorial Hospital

• All providers in Waterville, NY
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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.