Janie E Black, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

36256 Issued in TX

Practice address

1600 W 38TH St Ste 212
Austin, TX 78731-6405

Phone

(512) 324-3315

Fax

(512) 324-3314

NPI assigned

Oct 9, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: janie.black.1@16041.direct.athenahealth.com
• Direct secure messaging: janie.black.1@8363.direct.athenahealth.com

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.

• Tri-County Clinical

  • Family Medicine Physician
  • Luling, TX
  • NPI 1336456227
  Medicare reassignment NPD

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1407108814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST STE 212",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316405",
            "telephone_number": "512-324-3315",
            "fax_number": "512-324-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST STE 212",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316405",
            "telephone_number": "512-324-3315",
            "fax_number": "512-324-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JANIE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "36256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325199302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325199301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dandrea Black, RN
• Eileen Black
• Elvia Rivera Black, LCDC
• Emma Elizabeth Black, LCSW
• James N Black, MD
• Jason Alexander Black, DDS
• Jose Black, PT, DPT
• Kacie Black
• Lashawn Black, M.A. CCC-SLP
• Laura Elena Black, PT

• Clinical Child & Adolescent Psychologist in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Child & Adolescent Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.