Active NPI
Kerry Blackston
- Physical Therapist
- North Augusta, SC
National Provider Identifier
1427480409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 564
- Practice address
- 350 Austin Graybill Rd
North Augusta, SC 29860-9251 - Phone
- (803) 278-4272
- NPI assigned
- Aug 1, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 564 | SC | Primary |
| Physical Therapist | 225100000X | 000658 | GA |
Addresses
Primary practice location
350 Austin Graybill Rd
North Augusta, SC 29860-9251
Mailing address
350 Austin Graybill Rd
North Augusta, SC 29860-9251
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000658 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375315200000",
"number": "1427480409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 AUSTIN GRAYBILL RD",
"city": "NORTH AUGUSTA",
"state": "SC",
"postal_code": "298609251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 AUSTIN GRAYBILL RD",
"city": "NORTH AUGUSTA",
"state": "SC",
"postal_code": "298609251",
"telephone_number": "803-278-4272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKSTON",
"first_name": "KERRY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-01",
"last_updated": "2013-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "564",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "000658",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Augusta, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.