Vickie C Blackburn, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2650 Issued in SC

Practice address

1721 Ebenezer Rd Ste 175
Rock Hill, SC 29732-1188

Phone

(803) 324-5256

Fax

(803) 328-0440

NPI assigned

Jun 1, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Prep II LLCGroup PAC ID 1052835311, shared by 2 NPIs, 47 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Medical Center Hospital, Rock Hill, SC, CCN 420002

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as apm

Quality

81.63

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Novant Health Prep II LLC

  • Surgery Physician
  • Rock Hill, SC
  • NPI 1033910708
  Medicare reassignment NPD
• Novant Health Prep II LLC

  • Surgery Physician
  • Charlotte, NC
  • NPI 1952107385
  Medicare reassignment NPD
• Surgical Specialists of Charlotte, P.a.

  • Surgery Physician
  • Charlotte, NC
  • NPI 1073599734

  SC

  Medicare reassignment
• Novant Health Prep II LLC

  • Surgery Physician
  • Fort Mill, SC
  • NPI 1164228599
  NPD
• Novant Health Prep II LLC

  • Surgery Physician
  • Charlotte, NC
  • NPI 1033915442
  NPD
• Novant Health Prep II LLC

  • Surgery Physician
  • Huntersville, NC
  • NPI 1518763945
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amisub of South Carolina, Inc.

  • General Acute Care Hospital
  • Rock Hill, SC
  • NPI 1457382483
  Care Compare affiliation

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1487656708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604350",
            "telephone_number": "704-364-8100",
            "fax_number": "704-365-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 EBENEZER RD STE 175",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321188",
            "telephone_number": "803-324-5256",
            "fax_number": "803-328-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "VICKIE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "2650",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "2650",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5014444",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christian Birchfield
• William Robert Bixenman, MD
• Christopher Michael Black, D.C.
• Eddie Lamar Black Jr., PHARMD
• Chandler Elizabeth Blackburn
• Julie H Blackman, CNM
• Maria Blackmon
• Blackwell Eye Associates, P. a.
• David Michael Blackwell
• James Britt Blackwell, OD

• Nurse Practitioner in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.