Diera Blackwell, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

51686 Issued in SC

Practice address

377 Crystal LN
Walterboro, SC 29488-8972

Phone

(843) 599-3737

NPI assigned

Mar 16, 2021

Last updated

Mar 16, 2021By the provider in NPPES

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": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1851976419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 CRYSTAL LN",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294888972",
            "telephone_number": "843-599-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 CRYSTAL LN",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294888972",
            "telephone_number": "843-599-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "DIERA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SC",
            "license": "51686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer A. Berry, FNP
• Jodie Martin Bessinger, MPT
• John Frank Biggers, MD
• Kelly Bjorkman, OTR/L
• Donald R Black, MD
• Kayla Blocker, SLP
• Michael L Blubaugh, MD
• Bon Secours St Francis Xavier Hospital, Inc. (Charleston Oncology A Department of Bon Secours St. Francis Hospital)
• Phillip Jeffrey Bower, M.D.
• Boxwood Emergency Physicians, LLC

• Licensed Practical Nurse in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Licensed Practical Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.