Kelly Suzanne Black, RN, IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

212428 Issued in NC

Practice address

389 S Swing Rd
Greensboro, NC 27409-2009

Phone

(479) 445-4033

NPI assigned

Jan 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1642896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642896000000",
    "number": "1306598115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7803 PERTHSHIRE DR",
            "city": "OAK RIDGE",
            "state": "NC",
            "postal_code": "273108306",
            "telephone_number": "479-445-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 S SWING RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274092009",
            "telephone_number": "479-445-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KELLY",
        "middle_name": "SUZANNE",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-23",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NC",
            "license": "212428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Leigh Black, LCSWA
• Danielle Erica Black, MSN, APRN, FNP-C
• Holly Hood Black, NPP
• Jacquese Olean Black, DDS
• Karen M Black, NP
• Jennifer M Blackburn
• Rhonda Hardin Blackburn, MA
• Christopher Y Blackman, MD
• Douglas A Blackman, MD
• Loneke Blackman, RD

• Lactation Consultant (Registered Nurse) in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Lactation Consultant (Registered Nurse) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; 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.