Individual provider Active NPI

Ryan Black

  • Nurse Practitioner
  • Barberton, OH
National Provider Identifier
1245720374
Registry record updated May 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.022587 Issued in OH
Practice address
155 5TH St NE
Barberton, OH 44203-3332
Phone
(330) 715-1001
NPI assigned
May 14, 2018
Last updated
May 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.022587 OH Primary

Addresses

Primary practice location

155 5TH St NE
Barberton, OH 44203-3332

Mailing address

155 5TH St NE
Barberton, OH 44203-3332

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180608001778 OH Practitioner - Nurse Practitioner 0547515868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

155 5TH St NE
Barberton, OH 44203-3332

525 E Market St
Akron, OH 44304-1619

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.022587OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Medical Services, Inc. CurrentSince Jul 1, 2018 Accepting new patients
Summa Physicians LLC Current Accepting new patients
Summa Physicians LLC Nurse Practitioner CurrentSince May 29, 2018 Accepting new patients
Summa Physicians LLC CurrentSince May 29, 2018 Accepting new patients

Locations

4040 Embassy Pkwy
Ste 400
Akron, OH 44333
Phone (330) 576-4295

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

155 5th St NE
Barberton, OH 44203
Phone (330) 615-3000

6847 N Chestnut St
Ravenna, OH 44266
Phone (330) 296-9606

Interoperability endpoints

  • Direct secure messaging: rblack29001@summahealth-direct.org

Organizations & group practices 4

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1245720374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 5TH ST NE",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442033332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 5TH ST NE",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442033332",
            "telephone_number": "330-715-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.022587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barberton, OH

Sources for this page

Verify at the official NPI Registry.