Active NPI
Tina Roxanne Black, D.C.
- Chiropractor
- Clarksville, TN
National Provider Identifier
1104252931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC0000001775
- Practice address
- 664 Sango Rd
Clarksville, TN 37043 - Phone
- (931) 368-1996
- Fax
- (931) 368-0448
- NPI assigned
- Sep 25, 2013
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC0000001775 | TN | Primary |
Addresses
Primary practice location
664 Sango Rd
Clarksville, TN 37043
Mailing address
664 Sango Rd.
Clarksville, TN 37043
Phone (931) 368-1996
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1104252931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "664 SANGO RD.",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "37043",
"telephone_number": "931-368-1996",
"fax_number": "931-368-0448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "664 SANGO RD",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "37043",
"telephone_number": "931-368-1996",
"fax_number": "931-368-0448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "TINA",
"middle_name": "ROXANNE",
"name_prefix": "Ms.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-25",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TN",
"license": "DC0000001775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.