Elizabeth Black, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5010146 Issued in NC

Practice address

101 Cabarrus Ave E
Concord, NC 28025-3699

Phone

(888) 849-7379

Fax

(855) 857-7333

NPI assigned

Dec 3, 2017

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

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1512259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1508371386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253699",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-03",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5010146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Lynn Bixby
• Ebony Bizzell
• BJ'S Wholesale Club Inc.
• Black Wolf Health North Charlotte, LLC
• David Black, ACNP
• Marisa Black
• Megan Nicole Black
• Bradley Blackburn, LCMHC, NCC
• Kendra Scherrie Blackeagle, CRNA
• Cameron Trent Blackman, MD

• Family Nurse Practitioner in Concord, NC
• Providers in Concord, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.