Sherman B Blystone Jr., PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1009 Issued in NC

Practice address

101 Medical Drive
Elizabeth City, NC 27909

Phone

(252) 338-2114

Fax

(252) 338-2115

NPI assigned

Jan 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Coastal Rehabilitation Inc

  • Physical Therapist
  • Elizabeth City, NC
  • NPI 1457418311
  NPD
• Coastal Rehabilitation Inc

  • Physical Therapist
  • Manteo, NC
  • NPI 1346466430
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214265600000",
    "number": "1801953765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MEDICAL DRIVE",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "27909",
            "telephone_number": "252-338-2114",
            "fax_number": "252-338-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEDICAL DRIVE",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "27909",
            "telephone_number": "252-338-2114",
            "fax_number": "252-338-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLYSTONE",
        "first_name": "SHERMAN",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2008-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "1009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0779V",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B GROUP",
            "identifier": "271572B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "720779V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shayla Bishop, RBT
• Micaiah Blanchard, LCMHC
• Scott C Blanchard, DDS
• Jack Blitz
• Brittany Mann Blizzard
• Kelly Bond
• Jill Andrea Bonn, OTR/L
• Alison Boone, DDS
• Kelsey Copeland Booth, DNP, FNP-C
• Dana Nunes Boslau, RN

• Physical Therapist in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.