John Parker Blalock-Cornwel, LPN, CRCFA, ALCA

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN060987 Issued in GA

Practice address

108 McKelvey PL
Goose Creek, SC 29445-8215

Phone

(912) 341-7633

NPI assigned

Apr 24, 2023

Sex

Male

Sole proprietor

No

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 Apr 24, 2023.

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1508554080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 MCKELVEY PL",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294458215",
            "telephone_number": "912-341-7633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 MCKELVEY PL",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294458215",
            "telephone_number": "912-341-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK-CORNWEL",
        "first_name": "JOHN",
        "middle_name": "PARKER",
        "credential": "LPN, CRCFA, ALCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN060987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Berkeley County School District
• Berkeley County School Distsrict
• Scott H Berry, PSYD
• Cynthia Marie Biondo, LPN
• Marisa Jane Biro, SLP
• Bloom ABA
• Pernia Bobo-Mitchell, RRT
• Barbara Anne Boland, LPC
• Skylar Rose Bombardier
• Michelle Bonk, PTA

• All providers in Goose Creek, SC
• Licensed Practical Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.