NPIMap

Individual provider Active NPI

Cullen Black, MD

  • Family Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1487116166
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0000065115 Issued in TN
Practice address
941 Spring Creek Rd
Chattanooga, TN 37412-3909
Phone
(423) 894-7870
NPI assigned
Apr 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 0000065115 TN Primary

Addresses

Primary practice location

941 Spring Creek Rd
Chattanooga, TN 37412-3909

Mailing address

941 Spring Creek Rd
Chattanooga, TN 37412-3909
Phone (423) 894-7870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220722001021 TN Practitioner - Internal Medicine 0345621256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

975 E 3Rd St
Chattanooga, TN 37403-2173
Phone (423) 266-1490

Hospital & facility affiliations

  • Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0000065115TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of TN, LLC CurrentSince Apr 1, 2023 Accepting new patients
Erlanger Health Family Medicine CurrentSince Mar 10, 2025 Accepting new patients
Erlanger Health CurrentSince Mar 10, 2025 Accepting new patients
Chattanooga Hamilton County Hospital Authority Family Medicine Past Accepting new patients
Erlanger Health Past Accepting new patients

Locations

1100 E 3rd St
Chattanooga, TN 37403
Phone (423) 778-2957

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

941 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 855-3255

2300 Patterson St
#M
Nashville, TN 37203

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Organizations & group practices 13

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.

View all 13

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": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1487116166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 SPRING CREEK RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374123909",
            "telephone_number": "423-894-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 SPRING CREEK RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374123909",
            "telephone_number": "423-894-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CULLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "0000065115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.