Amy L Black, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN275748- COA1 Issued in OH

Practice address

30381 Chieftain Dr
Logan, OH 43138-9092

Phone

(740) 385-2555

Fax

(740) 380-3750

NPI assigned

Aug 12, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hopewell Health Centers, Inc.Group PAC ID 9234049990, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caretenders Vna Home health agency, Lancaster, OH, CCN 367137
• Hocking Valley Community Hospital Hospital, Logan, OH, CCN 361330
• Fairfield Medical Center Hospital, Lancaster, OH, CCN 360072

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Hopewell Health Centers Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Athens, OH
  • NPI 1699010348
  Medicare reassignment Care Compare group NPD
• Hopewell Health Centers Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Belpre, OH
  • NPI 1144732348
  NPD
• Hopewell Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Chillicothe, OH
  • NPI 1942291794
  NPD (past)

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

• Caretenders VS of Ohio, LLC

  • Home Health Agency
  • Lancaster, OH
  • NPI 1740434067
  Care Compare affiliation
• Fairfield Medical Center

  • General Acute Care Hospital
  • Lancaster, OH
  • NPI 1467433763
  Care Compare affiliation
• Hocking Valley Community Hospital

  • Critical Access Hospital
  • Logan, OH
  • NPI 1295840007
  Care Compare affiliation

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1033424148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456010188",
            "telephone_number": "740-773-4366",
            "fax_number": "740-775-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30381 CHIEFTAIN DR",
            "city": "LOGAN",
            "state": "OH",
            "postal_code": "431389092",
            "telephone_number": "740-385-2555",
            "fax_number": "740-380-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "AMY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-12",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "NP-11608",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "RN275748- COA1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3124318",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabrielle Bates
• Norma Beard
• Jayson Michael Beaulieu, CASE MANAGER
• Ruth Evelyn Bender, ADN
• Josie Benner, LISW
• Lanette L Blair, QMHS
• Daniel Bogue
• Julie Jessica Bolin-Rutherford, CNP
• Dalton Wayne Bond
• Ashley Bookwalter, LICDC-CS

• Family Nurse Practitioner in Logan, OH
• Providers in Logan, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.