Cheryl C Black, APRN-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN13431 Issued in TN

Practice address

715 Rugby Hwy
Robbins, TN 37852-3755

Phone

(423) 627-2782

Fax

(423) 627-2188

NPI assigned

Apr 25, 2008

Last updated

Nov 27, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mountain Peoples Health Councils Inc.

  dba Huntsville Primary Care Center

  • Federally Qualified Health Center (FQHC)
  • Huntsville, TN
  • NPI 1326049347
  NPD

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1366617854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 INDUSTRIAL LN",
            "city": "ONEIDA",
            "state": "TN",
            "postal_code": "378416294",
            "telephone_number": "423-286-4141",
            "fax_number": "423-286-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 RUGBY HWY",
            "city": "ROBBINS",
            "state": "TN",
            "postal_code": "378523755",
            "telephone_number": "423-627-2782",
            "fax_number": "423-627-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CHERYL",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "13431",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN13431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "13431",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN0000111356",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1513674",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marinda Gaye Botts, LPN
• Regina Elizabeth Carson, MSN, RN, APRN, CEN,
• Sandra Coffey, F.N.P.
• Compassion Caregivers (Sarah Gibson)
• Amber Nichole Foster, LPN

• Nurse Practitioner in Robbins, TN
• Providers in Robbins, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; 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.