Individual provider Active NPI

Kayla Blann, FNP-C

  • Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1902650120
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
29110 Issued in SC
Practice address
2294 Otranto Rd
Charleston, SC 29406-9603
Phone
(843) 225-2550
NPI assigned
Apr 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 29110 SC Primary

Addresses

Primary practice location

2294 Otranto Rd
Charleston, SC 29406-9603

Mailing address

2701 Sevier Ave Apt A11
Knoxville, TN 37920-2596
Phone (443) 988-1438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250203000832 SC Practitioner - Nurse Practitioner 5698204857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Pain Relief CenterGroup PAC ID 4981868593, 5 clinicians

Practice addresses (Care Compare)

2294 Otranto Rd
North Charleston, SC 29406-9603
Phone (843) 225-2550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29110SCMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Pain Relief Center CurrentSince Oct 10, 2024 Accepting new patients

Locations

2294 Otranto Rd
North Charleston, SC 29406
Phone (843) 225-2550

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1902650120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 SEVIER AVE APT A11",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379202596",
            "telephone_number": "443-988-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2294 OTRANTO RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294069603",
            "telephone_number": "843-225-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANN",
        "first_name": "KAYLA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "29110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.