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SALLY S BLAKE FNP-C
NPI 1750432985
Nurse Practitioner - Family in Orangeburg, SC

Active since January 15, 2007PECOS Enrolled
2319 SAINT MATTHEWS RD, ORANGEBURG, SC 29118(803) 536-1571(803) 534-3860 Get Directions Write a Review

NPPES record last updated: February 11, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 11, 2019, Jun 1, 2017 (2 updates tracked since 2017).

About Sally S Blake Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SALLY S BLAKE FNP-C (NPI 1750432985) is an individual family provider in Orangeburg, South Carolina, licensed in South Carolina (710) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1750432985
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameSALLY S BLAKECredential: FNP-C
Location Address2319 SAINT MATTHEWS RDOrangeburg, SC 29118
Mailing Address2319 Saint Matthews RdOrangeburg, SC 29118-2042 · (803) 536-1571 · Fax (803) 534-3860
Phone(803) 536-1571
Fax(803) 534-3860
Sole ProprietorNo
Enumeration DateJanuary 15, 2007
Last NPPES UpdateFebruary 11, 20192 updates tracked since enumeration
✔ NPI 1750432985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in SC · 710
2319 SAINT MATTHEWS RD, Orangeburg, SC 29118
Open in Google Maps ↗

Secondary Practice Locations 2

Location 186 Wren StBarnwell, SC 29812-1529 · Phone (803) 259-5762 · Fax (803) 259-3250
Location 2521 Gibson RdLexington, SC 29072-2551 · Phone (803) 951-3490 · Fax (803) 951-3557

Other Identifiers 3

OtherF710SC · Prescriptive Authority
Other710SC · State License #
MedicaidNP1060SC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sally S Blake Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sally Blake reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

South Carolina Dept Of Mental Health Accounting Office
Same address
Mental Health (Including Community Mental Health Center)
2319 ST MATTHEWS ROAD
Orangeburg, SC 29118
  • Reassigned Medicare billing, South Carolina enrollment
  • 79 clinicians in this Medicare group
NPI 1164457735 (803) 536-4571

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29118 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.18 typical visit price
range $53.57 – $163.84
Typical copayment $20.79 (range $13.39 – $40.96)
Most-billed visit code 99203
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLYN MOSLEY MASTER OF SCIENCE
Counselor (Mental Health)
2319 SAINT MATTHEWS RD
ORANGEBURG, SC 29118
Orangeburg County (803) 516-4254
MR. DENNIS RAY WADE I
Peer Specialist
2319 SAINT MATTHEWS RD
ORANGEBURG, SC 29118
Orangeburg County (803) 536-1571
STEPHANIE GREEN MA REHAB COUNSELING
Counselor (Mental Health)
2319 SAINT MATTHEWS RD
ORANGEBURG, SC 29118
Orangeburg County (803) 536-1571
KIMBERLY NICOLE HICKS LPC
Counselor (Mental Health)
2319 SAINT MATTHEWS RD
ORANGEBURG, SC 29118
Orangeburg County (803) 536-1571
QUAI STEPHENS
Counselor (Mental Health)
2319 SAINT MATTHEWS RD
ORANGEBURG, SC 29118
Orangeburg County (803) 536-1571
MRS. LATISCHA JACKSON HERRIOTT M.A.
Counselor (Mental Health)
2319 SAINT MATTHEWS RD
ORANGEBURG, SC 29118
Orangeburg County (803) 536-1571
BRYANT WILLIAMS
Counselor (Mental Health)
2319 SAINT MATTHEWS RD
ORANGEBURG, SC 29118
Orangeburg County (803) 536-1571
DREQUEZ MCFADDEN
Counselor (Mental Health)
2319 SAINT MATTHEWS RD
ORANGEBURG, SC 29118
Orangeburg County (803) 536-1571

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sally Blake's NPI number?

The NPI number for Sally Blake is 1750432985. It was assigned to this individual provider in the NPPES registry on January 15, 2007.

Where is Sally Blake located?

Sally Blake practices at 2319 Saint Matthews Rd, Orangeburg, SC 29118. The listed phone number is (803) 536-1571.

What is Sally Blake's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Sally Blake enrolled in Medicare?

Yes. Sally Blake is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sally Blake's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sally Blake reassigns Medicare benefits to South Carolina Dept Of Mental Health Accounting Office (Orangeburg, SC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sally Blake's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sally Blake was last updated on February 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.