Active NPI
Melissa Phillips Black, M.D.
- Geriatric Medicine (Family Medicine) Physician
- Atlanta, GA
National Provider Identifier
1376767483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Family Medicine) Physician
- License
- 056266
- Practice address
- 1365 Clifton Rd NE
Atlanta, GA 30322-1013 - Phone
- (404) 728-6363
- Fax
- (404) 728-6298
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | 056266 | GA | Primary |
Addresses
Primary practice location
1365 Clifton Rd NE
Atlanta, GA 30322-1013
Mailing address
1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 728-6363
Other names 1
- Dr. Melissa Marie Phillips
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2015 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empower Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- melissa.black@275282045763588.direct.elationemr.com
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Decatur, GA
- NPI 1093181000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341446400000",
"number": "1376767483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1365 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221013",
"telephone_number": "404-728-6363",
"fax_number": "404-728-6298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1365 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221013",
"telephone_number": "404-728-6363",
"fax_number": "404-728-6298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "MELISSA",
"middle_name": "PHILLIPS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2012-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "",
"desc": "Family Medicine, Geriatric Medicine",
"state": "GA",
"license": "056266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "PHILLIPS",
"middle_name": "MARIE",
"prefix": "DR.",
"credential": "M.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.