Joelle Ione Black, MPAS, PA-C
Individual provider Active NPI Physician Assistant · Temple, TX
NPI 1104196534 · NPPES record last updated Feb 25, 2021
Key facts
- NPI
- 1104196534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA13949 (TX)
- Practice address
- 2401 S 31St St
Temple, TX 76508-0001 - Phone
- (254) 724-2111
- Fax
- (254) 724-7603
- NPI assigned
- Jan 2, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Nebraska College of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Scott and White Clinic
Practice addresses (Care Compare)
1300 E Polk St
Baylor Scott and White Clinic Burnet
Burnet, TX 78611-2136
Phone (512) 715-6400
1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100
239 W Business
190 Baylor Scott and White Clinic Coppe
Copperas Cove, TX 76522-2912
Phone (254) 542-9000
2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459
2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663
5330 Overpass Rd
Buda, TX 78610-2300
810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585
Hospital & facility affiliations
- Baylor Scott & White Medical Center - Temple
- Baylor Scott & White Medical Center - Round Rock
- Baylor Scott & White Medical Center - Marble Falls
- Baylor Scott & White Medical Center- College Stati
- Baylor Scott & White Medical Center -Taylor
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210119001537 | TX | Practitioner - Physician Assistant | 5698188324 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott & White Hospital - Taylor | Past | Accepting new patients |
Interoperability endpoints
- jblack781558@direct.sw.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA13949 | TX | Yes |
Addresses
Primary practice location
2401 S 31St St
Temple, TX 76508-0001
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Other names
- Joelle Ione Chin
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jblack781558@direct.sw.org |
NPI Registry JSON
{
"created_epoch": "1325462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614211200000",
"number": "1104196534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 S 31ST ST",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765080001",
"telephone_number": "254-724-2111",
"fax_number": "254-724-7603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "JOELLE",
"middle_name": "IONE",
"credential": "MPAS, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-02",
"last_updated": "2021-02-25",
"certification_date": "2021-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA13949",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jblack781558@direct.sw.org",
"affiliation": "N",
"address_1": "2401 S 31st St",
"city": "Temple",
"state": "TX",
"country_code": "US",
"postal_code": "765080001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JOELLE",
"last_name": "CHIN",
"middle_name": "IONE",
"credential": "MPAS, PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.