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MISTY BLAYLOCK MA, CCC-SLP
NPI 1821597006
Speech-Language Pathologist in Berea, KY

Active since February 02, 2018Accepts Medicare Assignment
1043 BROOKLYN BLVD, BEREA, KY 40403(859) 228-0551 Get Directions Write a Review

NPPES record last updated: February 2, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Misty Blaylock Ma, Ccc-slp NPPES

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

MISTY BLAYLOCK MA, CCC-SLP (NPI 1821597006) is an individual speech-language pathologist provider in Berea, Kentucky, licensed in Kentucky (138621) and active in the NPI registry since February 2018. She is a graduate of Other (2009).

NPPES Registry Identity

NPI1821597006
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameMISTY BLAYLOCKCredential: MA, CCC-SLP
Location Address1043 BROOKLYN BLVDBerea, KY 40403-1090
Mailing Address1013 Cherry CtRichmond, KY 40475-8902
Phone(859) 228-0551
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateFebruary 2, 2018
✔ NPI 1821597006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in KY · 138621
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
1043 BROOKLYN BLVD, Berea, KY 40403
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Other Names 1

Former Name (1)Misty Parrott Ma, Ccc-slp

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Misty Blaylock Ma, Ccc-slp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8325485709
PECOS Enrollment IDI20240320003784

Medicare Billing Reassignment

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

Empowerme Rehabilitation Kentucky, LLC
33 mi
Multi-Specialty
1165 MONARCH ST
Lexington, KY 40513
  • Reassigned Medicare billing, Kentucky enrollment
  • 107 clinicians in this Medicare group
NPI 1275166696 (844) 502-7996

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

Other Providers at the Same Location NPPES 9

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

TERRI VALENCIA LCSW
Social Worker (Clinical)
1043 BROOKLYN BLVD
BEREA, KY 40403
Madison County (502) 262-2887
DR. BENJAMIN DANIEL JONES DPT
Physical Therapist
1043 BROOKLYN BLVD
BEREA, KY 40403
Madison County (859) 228-0551
BEREA AREA DEVELOPMENT LLC
Skilled Nursing Facility
1043 BROOKLYN BLVD
BEREA, KY 40403
Madison County (859) 228-0551
JESSICA LEE DAUGHERTY-PETERS OTRL
Occupational Therapist
1043 BROOKLYN BLVD
BEREA, KY 40403
Madison County (859) 779-8507
BACK OFFICE MANAGEMENT SERVICES LLC
Podiatrist
1043 BROOKLYN BLVD
BEREA, KY 40403
Madison County (718) 972-5000
MRS. ALESHIA ARIEL HARRIS OTR/L
Occupational Therapist
1043 BROOKLYN BLVD
BEREA, KY 40403
Madison County (859) 228-0551
AMANDA JANE HALE MA, CCC-SLP
Speech-Language Pathologist
1043 BROOKLYN BLVD
BEREA, KY 40403
Madison County (859) 228-0551
HALEY DOUGLAS KIDD MIDDLETON OTR/L
Occupational Therapist
1043 BROOKLYN BLVD
BEREA, KY 40403
Madison County (859) 228-0551

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 Misty Blaylock's NPI number?

The NPI number for Misty Blaylock is 1821597006. It was assigned to this individual provider in the NPPES registry on February 2, 2018. The provider is also known as Misty Parrott Ma, Ccc-Slp.

Where is Misty Blaylock located?

Misty Blaylock practices at 1043 Brooklyn Blvd, Berea, KY 40403. The listed phone number is (859) 228-0551.

What is Misty Blaylock's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Misty Blaylock enrolled in Medicare?

Yes. Misty Blaylock is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Misty Blaylock's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Misty Blaylock reassigns Medicare benefits to Empowerme Rehabilitation Kentucky, LLC (Lexington, KY). 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 Misty Blaylock'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 Misty Blaylock was last updated on February 2, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.