Individual provider Active NPI

Kara N Black, PAC

  • Physician Assistant
  • Elkins, WV
National Provider Identifier
1003140914
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
01432 Issued in WV
Practice address
213 Main St
Elkins, WV 26241-4161
Phone
(304) 637-2360
NPI assigned
Sep 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 01432 WV Primary

Addresses

Primary practice location

213 Main St
Elkins, WV 26241-4161

Mailing address

213 Main St
Elkins, WV 26241-4161
Phone (304) 637-2360

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address kblack154813@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address kblack154813@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address kblack154813@direct.wvuhsdirect.com Health Information Exchange (HIE)
Direct Messaging Address kblack154813@direct.wvuhsdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20091110000026 WV Practitioner - Physician Assistant 2769520998 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Joseph'S Hospital of Buckhannon IncGroup PAC ID 6709828163, 98 clinicians

Practice addresses (Care Compare)

94 W Main St
Buckhannon, WV 26201-2284
Phone (304) 473-2199

Hospital & facility affiliations

  • St Joseph'S Hospital of Buckhannon, Inc Hospital, Buckhannon, WV, CCN 511321
  • United Hospital Center, Inc Hospital, Bridgeport, WV, CCN 510006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1432WVMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Hospital of Buckhannon Inc CurrentSince Mar 23, 2020 Accepting new patients
St Josephs Hospital of Buckhannon Past Accepting new patients
West Virginia Gastroenterology & Endoscopy Past Accepting new patients

Locations

1 Amalia Dr
Buckhannon, WV 26201
Phone (304) 473-2000

94 W Main St
Ste 201
Buckhannon, WV 26201

21 Auction Ln
Ste A
Buckhannon, WV 26201
Phone (304) 472-6041

21 Auction Ln
Buckhannon, WV 26201
Phone (304) 472-0245

Interoperability endpoints

  • Direct secure messaging: kblack154813@direct.wvuhsdirect.com
  • Direct secure messaging: knb630pcs@m1696.primeclinicalsystems.direct-ci.com

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1003140914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 MAIN ST",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262414161",
            "telephone_number": "304-637-2360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 MAIN ST",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262414161",
            "telephone_number": "304-637-2360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KARA",
        "middle_name": "N",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-24",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kblack154813@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Auction Ln",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262018968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kblack154813@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Auction Ln Ste A",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262018968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kblack154813@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Auction Ln Ste A",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262018968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kblack154813@direct.wvuhsdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21 Auction Ln Ste A",
            "city": "Buckhannon",
            "state": "WV",
            "country_code": "US",
            "postal_code": "262018968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elkins, WV

Sources for this page

Verify at the official NPI Registry.