Samuel a Black, MD, LLC

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

MD5514 Issued in SC

Legal business name

SAMUEL A BLACK, MD, LLC

Practice address

129 N Washington St
Sumter, SC 29150-4949

Phone

(800) 228-0249

Fax

(252) 222-3602

NPI assigned

Oct 9, 2006

Organization subpart

No

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

Authorized official

Name

Samuel A Black Sr., MD

Title

President

Phone

(800) 228-0249

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265529499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285570039",
            "telephone_number": "800-228-0249",
            "fax_number": "252-222-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 N WASHINGTON ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504949",
            "telephone_number": "800-228-0249",
            "fax_number": "252-222-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL A BLACK, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-228-0249",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": "SC",
            "license": "MD5514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055148",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anuraag Sah, MD
• Jose R Salcedo-Contreras, M.D.
• Elise P Salerno, M.D.
• Sahlee J Salzer, PT, DPT
• Christopher Bernard Sampair, D.D.S.
• Brandolyn Janelle Samuel
• Chrishonda Samuel
• Carline Verona Samuels
• Ivan Thomas Sanders, LMSW
• Mia Sanders

• Rehabilitation Practitioner in Sumter, SC
• Providers in Sumter, SC by specialty
• Rehabilitation Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.