Heidi Yasmene Blaylock, FNP-C, ANP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

22473 Issued in CA

Practice address

1601 Brenner Ave
Salisbury, NC 28144

Phone

(704) 638-9000

NPI assigned

Nov 1, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1790039402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 OAKWOOD AVE",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280819452",
            "telephone_number": "757-377-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 BRENNER AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "28144",
            "telephone_number": "704-638-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41880 Kalmia St",
            "address_2": "suite 100",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925628831",
            "country_code": "US",
            "telephone_number": "951-461-6963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41880 Kalmia St",
            "address_2": "suite 100",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925628831",
            "country_code": "US",
            "telephone_number": "951-461-6963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAYLOCK",
        "first_name": "HEIDI",
        "middle_name": "YASMENE",
        "credential": "FNP-C, ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "22473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Salisbury, NC
• Providers in Salisbury, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.