Matthew L Black, MS, RDN, LD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

5343 Issued in OH

Practice address

160 W Wilson Bridge Rd
Worthington, OH 43085-2676

Phone

(614) 293-5123

Fax

(614) 293-4980

NPI assigned

Aug 20, 2018

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

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osu General Internal Medicine LLCGroup PAC ID 7517103955, 270 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Osu General Internal Medicine LLC

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1689919599
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1366922247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-5123",
            "fax_number": "614-293-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W WILSON BRIDGE RD",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852676",
            "telephone_number": "614-293-5123",
            "fax_number": "614-293-4980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 W 10th Ave",
            "address_2": "W180 Doan Hall",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "43210",
            "country_code": "US",
            "telephone_number": "614-293-8036",
            "fax_number": "614-293-3780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MATTHEW",
        "middle_name": "L",
        "credential": "MS, RDN, LD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-20",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OH",
            "license": "5343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Jo Bishop, MSW, LISW-S
• Himal Biswa
• Morgan Lynn Bitzel, PA
• Siobhan Blanche Bivens
• Zorica Bjelovuk, CNP
• Kaylea Blackburn
• Joyce Blackmon
• Jasmen Blackwell
• Victoria Blackwell
• Chelsea Blaine

• Registered Dietitian in Worthington, OH
• Providers in Worthington, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.