Active NPI
Garrett Black
- Family Medicine Physician
- Meridian, MS
National Provider Identifier
1225829179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- BLAC-CVY41K
- Practice address
- 905C S Frontage Rd
Meridian, MS 39301-6113 - Phone
- (601) 482-4955
- NPI assigned
- May 12, 2025
- Last updated
- May 12, 2025
- Sex
- Unspecified or another gender identity
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | BLAC-CVY41K | MS | Primary |
Addresses
Primary practice location
905C S Frontage Rd
Meridian, MS 39301-6113
Mailing address
905C S Frontage Rd
Meridian, MS 39301-6113
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 |
|---|---|---|---|
| BLAC-CVY41K | MS | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747008000000",
"number": "1225829179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905C S FRONTAGE RD",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393016113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905C S FRONTAGE RD",
"city": "MERIDIAN",
"state": "MS",
"postal_code": "393016113",
"telephone_number": "601-482-4955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "GARRETT",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-05-12",
"last_updated": "2025-05-12",
"certification_date": "2025-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MS",
"license": "BLAC-CVY41K",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.