Kelli Black

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

724 Quilliams Rd
Cleveland Heights, OH 44121-1956

Phone

(216) 512-5929

NPI assigned

Oct 19, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1104589878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 QUILLIAMS RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441211956",
            "telephone_number": "216-512-5929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 QUILLIAMS RD",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441211956",
            "telephone_number": "216-512-5929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2023-12-07",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yash Bhattarai, MD
• Jaskomal Veer Kaur Bhullar, MD
• Margaret Mary Bigg, M.D.
• Crystal Bivens
• Jane Beth Black, M.D.
• Kimberly Ann Blackburn, ATC
• Jayla Blackmon
• Crystal S Blake, PC
• Londone Blake
• Kevin Bleistein, LISW

• Contractor in Cleveland Heights, OH
• Providers in Cleveland Heights, OH by specialty
• Contractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.