Individual provider Active NPI

Whitney Kaylan Black, MD

  • Internal Medicine Physician
  • Chattanooga, TN
National Provider Identifier
1497990170
Registry record updated Jan 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50991 Issued in TN
Practice address
2525 Desales Avenue
Chattanooga, TN 37404
Phone
(423) 495-7404
Fax
(423) 495-2625
NPI assigned
Dec 9, 2008
Last updated
Jan 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50991 TN Primary
Hospitalist Physician 208M00000X 50991 TN

Addresses

Primary practice location

2525 Desales Avenue
Chattanooga, TN 37404

Mailing address

1949 Gunbarrel Road
Suite 230
Chattanooga, TN 37421
Phone (423) 495-4349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NC, GA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140909001845 TN Practitioner - Internal Medicine 9032355730 Reassigns benefits to 1 organization
I20170605000026 NC Practitioner - Internal Medicine 9032355730 Reassigns benefits to 1 organization
I20180820002314 GA Practitioner - Internal Medicine 9032355730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Mercer University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Gross Crescent Cir
Fort Oglethorpe, GA 30742-3643
Phone (706) 858-2445

2525 Desales Ave
Chattanooga, TN 37404-1161
Phone (423) 495-2525

4710 Battlefield Pkwy
Ringgold, GA 30736-5164
Phone (423) 495-2525

4750 Battlefield Pkwy
Ringgold, GA 30736-5164
Phone (706) 841-8050

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50991TNMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Murphy Medical Center, Inc. Hospitalist CurrentSince Mar 13, 2017 Accepting new patients
Murphy Medical Center Inc Current Accepting new patients
Memorial Health Partners Foundation Inc CurrentSince Jan 10, 2018 Accepting new patients
Memorial Health Partners Foundation, Inc Internal Medicine CurrentSince Jan 10, 2018 Accepting new patients
Murphy Medical Center, Inc. CurrentSince Mar 13, 2017 Accepting new patients

Locations

611 E Villanow St
La Fayette, GA 30728
Phone (706) 638-1606

3990 US Highway 64 E
Murphy, NC 28906
Phone (828) 837-5939

2525 Desales Ave
Chattanooga, TN 37404
Phone (423) 495-2620

5600 Brainerd Rd
Ste 500
Chattanooga, TN 37411
Phone (423) 414-3586

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 3

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": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515110400000",
    "number": "1497990170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 GUNBARREL ROAD",
            "address_2": "SUITE 230",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421",
            "telephone_number": "423-495-4349",
            "fax_number": "423-495-4934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 DESALES AVENUE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-495-7404",
            "fax_number": "423-495-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "WHITNEY",
        "middle_name": "KAYLAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2018-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "50991",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "50991",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.