Ryan Black
Individual provider Active NPI Nurse Practitioner · Barberton, OH
NPI 1245720374 · NPPES record last updated May 14, 2018
Key facts
- NPI
- 1245720374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN.CNP.022587 (OH)
- Practice address
- 155 5TH St NE
Barberton, OH 44203-3332 - Phone
- (330) 715-1001
- NPI assigned
- May 14, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Summa Physicians LLC
Practice addresses (Care Compare)
155 5TH St NE
Barberton, OH 44203-3332
525 E Market St
Akron, OH 44304-1619
Hospital & facility affiliations
- Summa Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180608001778 | OH | Practitioner - Nurse Practitioner | 0547515868 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN.CNP.022587 | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summa Physicians LLC | Current | Accepting new patients | |
| Summa Physicians LLC | Current |
Accepting new patients | |
| Inpatient Medical Services, Inc. | Current |
Accepting new patients | |
| Summa Physicians LLC | Nurse Practitioner | Current |
Accepting new patients |
Locations
525 E Market St
Akron, OH 44304
Phone (330) 375-6350
4040 Embassy Pkwy
Ste 400
Akron, OH 44333
Phone (330) 576-4295
155 5th St NE
Barberton, OH 44203
Phone (330) 615-3000
6847 N Chestnut St
Ravenna, OH 44266
Phone (330) 296-9606
Interoperability endpoints
- rblack29001@summahealth-direct.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN.CNP.022587 | OH | Yes |
Addresses
Primary practice location
155 5TH St NE
Barberton, OH 44203-3332
Mailing address
155 5TH St NE
Barberton, OH 44203-3332
Other providers in Barberton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.