Active NPI
Sandra Black, 376J00000X
- Homemaker
- Columbus, OH
National Provider Identifier
1033527833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- 2975099
- Practice address
- 1155 S Champion Ave
Columbus, OH 43206-3025 - Phone
- (614) 648-2311
- Fax
- (614) 648-2311
- NPI assigned
- Jul 25, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homemaker | 376J00000X | 2975099 | OH | Primary |
Addresses
Primary practice location
1155 S Champion Ave
Columbus, OH 43206-3025
Mailing address
1155 S Champion Ave
Columbus, OH 43206-3025
Phone (614) 648-2311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2975099 | OH | MD | Homemaker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406246400000",
"number": "1033527833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1155 S CHAMPION AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432063025",
"telephone_number": "614-648-2311",
"fax_number": "614-648-2311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1155 S CHAMPION AVE",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432063025",
"telephone_number": "614-648-2311",
"fax_number": "614-648-2311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "SANDRA",
"credential": "376J00000X",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-25",
"last_updated": "2014-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "OH",
"license": "2975099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.