Jason L Black, APRN-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12510 Issued in TN

Practice address

1407 W Baddour Pkwy
Lebanon, TN 37087-2513

Phone

(615) 444-6203

Fax

(615) 444-6252

NPI assigned

May 9, 2008

Last updated

Jun 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, TX, IA, OR, AL5 enrollments

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 5

Specialty

Nurse Practitioner

Education

Vanderbilt University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Medical PCGroup PAC ID 4486544970, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tristar Summit Medical Center Hospital, Hermitage, TN, CCN 440150
• Vanderbilt Wilson County Hospital Hospital, Lebanon, TN, CCN 440193

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17814/brand/1/csg/1/fhir/r4

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.

• Family Medical PC

  dba Family Medical Associates

  • Specialist
  • Lebanon, TN
  • NPI 1295805794
  Medicare reassignment Care Compare group
• Icco, LLC

  dba BestMed

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment NPD
• QV Urgent Care Ia PLLC

  dba QuickVisit Urgent Care

  • Urgent Care Clinic/Center
  • Mt Pleasant, IA
  • NPI 1407465917
  Medicare reassignment NPD
• QV Urgent Care TX PLLC

  dba QuickVisit Urgent Care

  • Family Medicine Physician
  • Henderson, TX
  • NPI 1568098887
  Medicare reassignment NPD
• Southern Immediate Care, LLC

  • Urgent Care Clinic/Center
  • Anniston, AL
  • NPI 1467909978
  Medicare reassignment NPD
• Stopwatch Urgent Care Centers LLC

  dba Moore's Mill Urgent Care

  • Urgent Care Clinic/Center
  • Auburn, AL
  • NPI 1841506458
  Medicare reassignment NPD
• Icco LLC

  dba BestMed

  • Rural Health Clinic/Center
  • Florence, OR
  • NPI 1740896547
  NPD
• Keel and Associates

  • General Practice Physician
  • Oxford, AL
  • NPI 1720136443
  NPD
• QV Urgent Care Ia PLLC

  dba Quickvisit Urgent Care

  • Rural Health Clinic/Center
  • Washington, IA
  • NPI 1235835950
  NPD
• QV Urgent Care TX PLLC

  dba QuickVisit Urgent Care

  • Rural Health Clinic/Center
  • Madisonville, TX
  • NPI 1669198347
  NPD
• Peak Health and Wellness, PLLC

  dba Nova Health

  • Urgent Care Clinic/Center
  • Belgrade, MT
  • NPI 1902181563
  NPD (past)

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

• HCA Health Services of Tennessee, Inc.

  dba Tristar Summit Medical Center

  • General Acute Care Hospital
  • Hermitage, TN
  • NPI 1982650024
  Care Compare affiliation
• Vanderbilt University Medical Center

  dba Vanderbilt Wilson County Hospital

  • General Acute Care Hospital
  • Lebanon, TN
  • NPI 1306889597
  Care Compare affiliation

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1306013305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 W BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872513",
            "telephone_number": "615-444-6203",
            "fax_number": "615-444-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 W BADDOUR PKWY",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370872513",
            "telephone_number": "615-444-6203",
            "fax_number": "615-444-6252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 US Highway 79 S",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "TX",
            "postal_code": "756544508",
            "country_code": "US",
            "telephone_number": "903-717-3260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JASON",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-09",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP145757",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Victoria Berry, OD
• Best Care Services
• Irene Florence Bible, M.S.,CCC-SLP
• Adelia Lee Birdwell, PA-C
• Vaibhav Singh Bisht
• Jennifer Rose Black
• Matthew Elisha Black
• Kristy M Blaney, RN, APRN
• Jaime Christen Blaylock, APRN-C
• Laura F Boggan, MS NCP

• Family Nurse Practitioner in Lebanon, TN
• Providers in Lebanon, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.