Monica Lee Black, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD17892 Issued in TN

Practice address

4741 N Broadway St
Knoxville, TN 37918-1793

Phone

(865) 687-1940

Fax

(865) 687-0157

NPI assigned

Nov 28, 2006

Last updated

Jul 8, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457427585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4741 N BROADWAY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379181793",
            "telephone_number": "865-687-1940",
            "fax_number": "865-687-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 N BROADWAY ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379181793",
            "telephone_number": "865-687-1940",
            "fax_number": "865-687-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MONICA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD17892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurel Black
• Lauren Black
• Lucinda Black, LMFT
• Makenna Black
• Michelle Black, PH.D.
• Olivia Black, OTR/L
• Sarah Black, PA-C
• Timothy R. Black, PA-C
• Tyler Black
• William D Black, MD

• Pediatrics Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.