Rosa Elena Black

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1171100 Issued in TX

Practice address

10208 Quaker Ave Ste 200
Lubbock, TX 79424-8394

Phone

(806) 795-4500

Fax

(806) 740-3325

NPI assigned

Aug 22, 2024

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grace Clinic of Lubbock

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1912953357
  NPD

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1154154425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10208 QUAKER AVE STE 200",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794248394",
            "telephone_number": "806-795-4500",
            "fax_number": "806-740-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ROSA",
        "middle_name": "ELENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1171100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arica Grace Black, AUD
• Carrie Sue Black, SLP
• Cynthia Black, RPH
• Lashonda Nicole Black, LCDC-I
• Nicole Black, PHD, LPC-S, LCDC RPT
• Sandra Ra'Chelle Black, ATC
• Anita Faye Blackburn
• Ashley Sledge Blackstock, OTR/L
• David Eric Blackwell, M.D.
• Caitlin Sarah Blair, BSN, MSN, FNP-C

• Family Nurse Practitioner in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.