Paul Clifford Black, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2020030965 Issued in MO

Practice address

100 Lantana Rd Ste 202
Crossville, TN 38555-1903

Phone

(931) 484-5141

Fax

(865) 374-2074

NPI assigned

Aug 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Quality Home Health Home health agency, Jamestown, TN, CCN 447406
• Adoration Home Health Nashville South Home health agency, Cookeville, TN, CCN 447425
• Cumberland Medical Center Hospital, Crossville, TN, CCN 440009

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: black.paul.clifford@covenanthealth.cernerdirect.com
• Direct secure messaging: black@mrfm.gwaydirect.com

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

• Covenant Medical Group, Inc.

  • Family Medicine Physician
  • Knoxville, TN
  • NPI 1457302010

  Family Medicine, TN

  Medicare reassignment Care Compare group NPD
• Coremedx Inc.

  • General Practice Physician
  • Danville, VA
  • NPI 1275175705

  VA

  Medicare reassignment NPD
• Covenant Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Knoxville, TN
  • NPI 1871269415
  NPD

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

• Abilishealth Nashville, LLC

  • Home Health Agency
  • Brentwood, TN
  • NPI 1346720398
  Care Compare affiliation
• All Care Plus Inc.

  • Home Health Agency
  • Jamestown, TN
  • NPI 1629073614
  Care Compare affiliation
• Cumberland Medical Center, Inc.

  • General Acute Care Hospital
  • Crossville, TN
  • NPI 1871596403

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1285825836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 GW LN",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832339",
            "telephone_number": "573-774-2715",
            "fax_number": "573-202-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LANTANA RD STE 202",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385551903",
            "telephone_number": "931-484-5141",
            "fax_number": "865-374-2074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 Kane St",
            "address_purpose": "LOCATION",
            "city": "Gate City",
            "state": "VA",
            "postal_code": "242512753",
            "country_code": "US",
            "telephone_number": "276-386-3411",
            "fax_number": "276-386-3492",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Gw Ln",
            "address_purpose": "LOCATION",
            "city": "Waynesville",
            "state": "MO",
            "postal_code": "655832339",
            "country_code": "US",
            "telephone_number": "573-774-2715",
            "fax_number": "573-202-2410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "PAUL",
        "middle_name": "CLIFFORD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101244723",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "44017",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2020030965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLACK LUNG",
            "identifier": "165699202",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q009679",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "621584391013",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Black.paul.clifford@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Lantana Rd Ste 202",
            "city": "Crossville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "385551903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Crossville, TN
• Providers in Crossville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.