Makenna Black

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

35631 Issued in TN

Practice address

1930 Alcoa Hwy Ste 145
Knoxville, TN 37920-1546

Phone

(865) 305-9749

NPI assigned

Feb 2, 2024

Last updated

Feb 2, 2024By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1706832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1215790274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7216 HALLBROOK RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379189419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 ALCOA HWY STE 145",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201546",
            "telephone_number": "865-305-9749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MAKENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "35631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Lee Black, RN-BC
• Kathryn Marie Black, LPN
• Laurel Black
• Lauren Black
• Lucinda Black, LMFT
• Michelle Black, PH.D.
• Monica Lee Black, M.D.
• Olivia Black, OTR/L
• Sarah Black, PA-C
• Timothy R. Black, PA-C

• Pediatric Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.