Chad Black MD, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CHAD BLACK MD, LLC

Practice address

610 Sycamore Street Suite 130
Celebration, FL 34747

Phone

(321) 287-6955

NPI assigned

Oct 10, 2013

Organization subpart

Yes

Parent organization

TOWN CENTER FAMILY MEDICINE LLCAs reported in NPPES

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

Authorized official

Name

Chad Black, MD

Title

Ceo / Medical Director

Phone

(321) 287-6955

Specialties & licenses 1

Addresses

Part of

Town Center Family Medicine LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Town Center Family Medicine LLC

  • Family Medicine Physician
  • Celebration, FL
  • NPI 1790047934
  NPPES parent name

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381363200000",
    "number": "1538596309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 SYCAMORE STREET SUITE 130",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "34747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SYCAMORE STREET SUITE 130",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "34747",
            "telephone_number": "321-287-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAD BLACK MD, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOWN CENTER FAMILY MEDICINE LLC",
        "enumeration_date": "2013-10-10",
        "last_updated": "2013-10-10",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CEO / MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "321-287-6955",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Celebration, FL
• Providers in Celebration, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.