Active NPI
Stephen Anthony Black, PD
- Pharmacist
- Cullman, AL
National Provider Identifier
1104411537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9944
- Practice address
- 145 County Road 1147
Cullman, AL 35057-1211 - Phone
- (256) 338-2217
- NPI assigned
- Mar 8, 2021
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9944 | AL | Primary |
Addresses
Primary practice location
145 County Road 1147
Cullman, AL 35057-1211
Mailing address
145 County Road 1147
Cullman, AL 35057-1211
Phone (256) 338-2217
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9944 | Other | AL | ALABAMA STATE BOARD OF PHARMACY |
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 |
|---|---|---|---|
| 9944 | AL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1104411537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 COUNTY ROAD 1147",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350571211",
"telephone_number": "256-338-2217",
"fax_number": "256-615-6666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 COUNTY ROAD 1147",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350571211",
"telephone_number": "256-338-2217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "STEPHEN",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "PD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-08",
"last_updated": "2021-03-08",
"certification_date": "2021-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "9944",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALABAMA STATE BOARD OF PHARMACY",
"identifier": "9944",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cullman, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.