Donald R Black, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101280774 Issued in VA

Practice address

501 Robertson Blvd
Walterboro, SC 29488-2787

Phone

(704) 782-2000

NPI assigned

Jan 24, 2006

Last updated

Feb 5, 2024By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dblack2707807@carolinashealthcaresystem.direct-ci.com

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.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment NPD
• Southeastern Hospitalist Services PC

  • Hospitalist Physician
  • Myrtle Beach, SC
  • NPI 1003280108
  Medicare reassignment NPD

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1306816368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882787",
            "telephone_number": "704-201-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 ROBERTSON BLVD",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882787",
            "telephone_number": "704-782-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Martha Jefferson Dr",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229114668",
            "country_code": "US",
            "telephone_number": "434-654-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DONALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101280774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7916020",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sydney Benson, PT, DPT
• Jennifer A. Berry, FNP
• Jodie Martin Bessinger, MPT
• John Frank Biggers, MD
• Kelly Bjorkman, OTR/L
• Diera Blackwell, LPN
• Kayla Blocker, SLP
• Michael L Blubaugh, MD
• Bon Secours St Francis Xavier Hospital, Inc. (Charleston Oncology A Department of Bon Secours St. Francis Hospital)
• Phillip Jeffrey Bower, M.D.

• Pediatrics Physician in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Pediatrics Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.