Gerri Monique Black, PA

Primary specialty

Surgical Oncology PhysicianTaxonomy code 2086X0206X

License

1229443 Issued in TN

Practice address

721 Glenwood Dr Ste 560
Chattanooga, TN 37404-1129

Phone

(423) 622-2494

NPI assigned

Jan 13, 2025

Last updated

Jan 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Physician Assistant

Education

Lincoln Memorial University Medical Department, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Health Partners Foundation IncGroup PAC ID 8022919570, 458 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gblack454526@direct.stlukeshealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Memorial Health Partners Foundation, Inc

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1922053545
  Medicare reassignment Care Compare group NPD
• Memorial Health Partners Foundation Inc

  dba CHI Memorial Family Practice Associates - Lafayette

  • Rural Health Clinic/Center
  • La Fayette, GA
  • NPI 1760632780
  NPD

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

• Memorial Health Care System Inc.

  dba Memorial Hospital Hixson

  • General Acute Care Hospital
  • Hixson, TN
  • NPI 1083778633
  Care Compare affiliation
• Memorial Health Care System Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1255428736
  Care Compare affiliation

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1073323994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 S MERIDIAN ST # B",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462252022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 GLENWOOD DR STE 560",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041129",
            "telephone_number": "423-622-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "GERRI",
        "middle_name": "MONIQUE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TN",
            "license": "1229443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BJ's Wholesale Club Inc.
• Melissa A Blach, L..P.N.
• Chariti Black, NP-C
• Cullen Black, MD
• Emily Lauren Black, PA
• Jessica Fusco Black, BCBA
• Joshua Paul Black, APN
• Lacie Black, NP-C
• Matthew A. Black, LPC
• Robert Black

• Surgical Oncology Physician in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Surgical Oncology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.