Active NPI
Diane Elaine Black, MS,RD,CDE
- Registered Dietitian
- Salem, VA
National Provider Identifier
1114258357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 572543
- Practice address
- 2157 Apperson Dr
Salem, VA 24153-7235 - Phone
- (540) 777-0000
- NPI assigned
- Jan 28, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 572543 | PA | Primary |
Addresses
Primary practice location
2157 Apperson Dr
Salem, VA 24153-7235
Mailing address
10102 Edgecombe PL NE
Bainbridge Island, WA 98110-4334
Phone (412) 400-3204
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 572543 | PA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264636800000",
"number": "1114258357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10102 EDGECOMBE PL NE",
"city": "BAINBRIDGE ISLAND",
"state": "WA",
"postal_code": "981104334",
"telephone_number": "412-400-3204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2157 APPERSON DR",
"city": "SALEM",
"state": "VA",
"postal_code": "241537235",
"telephone_number": "540-777-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "DIANE",
"middle_name": "ELAINE",
"name_prefix": "Ms.",
"credential": "MS,RD,CDE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-28",
"last_updated": "2010-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "572543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.