Individual provider Active NPI

Laurie Ann Black, RN, FNP-C

  • Family Nurse Practitioner
  • Columbus, IN
National Provider Identifier
1376109736
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009191A Issued in IN
Practice address
2138 25TH St Ste F
Columbus, IN 47201-3241
Phone
(812) 376-3100
Fax
(812) 378-6191
NPI assigned
May 11, 2019
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28200199A IN
Family Nurse Practitioner 363LF0000X 71009191A IN Primary

Addresses

Primary practice location

2138 25TH St Ste F
Columbus, IN 47201-3241

Mailing address

PO Box 775383
Chicago, IL 60677-5383
Phone (812) 376-5315

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lblack18988@edirect.crh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190829001454 IN Practitioner - Nurse Practitioner 6709114796 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2138 25TH St
Suite F
Columbus, IN 47201-3241
Phone (812) 376-3100

2400 17TH St
Columbus, IN 47201-5351
Phone (812) 376-5974

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.97 of 100Reported as apm
Quality
85.1
Promoting interoperability
94.69
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
28200199AINMDFamily Nurse Practitioner
71009191AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Physicians, LLC CurrentSince Sep 1, 2019 Accepting new patients
LB Healing Hands LLC Family CurrentSince Mar 5, 2025 Accepting new patients
Columbus Regional Health Physicians, LLC CurrentSince Sep 1, 2019 Accepting new patients
Major Hospital Past Accepting new patients
Columbus Regional Health Physicians, LLC Past Accepting new patients

Locations

1655 N Gladstone Ave
Ste A
Columbus, IN 47201
Phone (812) 376-3100

2138 25th St
Ste F
Columbus, IN 47201
Phone (812) 376-3100

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

3015 10th St
Columbus, IN 47201
Phone (812) 376-5373

411 W Tipton St
Seymour, IN 47274
Phone (317) 888-3505

Interoperability endpoints

  • Direct secure messaging: lblack18988@edirect.crh.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1557532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1376109736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315",
            "fax_number": "812-375-3477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2138 25TH ST STE F",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013241",
            "telephone_number": "812-376-3100",
            "fax_number": "812-378-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "LAURIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-11",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28200199A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009191A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lblack18988@edirect.crh.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "1655 N Gladstone Ave Ste A",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.