Leah Autry Black, PA C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

102900 Issued in NC

Practice address

1327 Robeson St
Fayetteville, NC 28305-5531

Phone

(910) 486-5437

Fax

(910) 486-5437

NPI assigned

Aug 26, 2005

Last updated

Jul 21, 2022By 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

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: leahblack@rpf.allscriptsdirect.net

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.

• Rainbow Pediatrics of Fayetteville

  • Pediatrics Physician
  • Fayetteville, NC
  • NPI 1356439566
  NPD
• Rainbow Pediatrics

  • Neonatal Nurse Practitioner
  • Fayetteville, NC
  • NPI 1699148445
  NPD (past)

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1518950369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 ROBESON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055531",
            "telephone_number": "910-486-5437",
            "fax_number": "910-486-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 ROBESON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055531",
            "telephone_number": "910-486-5437",
            "fax_number": "910-486-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "LEAH",
        "middle_name": "AUTRY",
        "name_prefix": "Mrs.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Black, PA
• Barbara Black, M.S., LCAS
• Catarrus Black
• Chelsea Gebs Black, PA-C
• Kelly Black, OTR/L
• Melissa Black, LCSW-A
• Shelia Maria Black, DNP, NP-C
• Amanda Raine Blackburn
• Tracy Blackmon-Paylor
• Cheryl Blackmon, LCASA

• Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.