Ross R Black II, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35036057B Issued in OH

Practice address

265 Portage Trail Ext W
Suite 200
Cuyahoga Falls, OH 44223-3613

Phone

(330) 928-3111

Fax

(330) 928-2843

NPI assigned

Aug 2, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609883313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 PORTAGE TRAIL EXT W",
            "address_2": "SUITE 200",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442233613",
            "telephone_number": "330-928-3111",
            "fax_number": "330-928-2843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 PORTAGE TRAIL EXT W",
            "address_2": "SUITE 200",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "442233613",
            "telephone_number": "330-928-3111",
            "fax_number": "330-928-2843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ROSS",
        "middle_name": "R",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35036057B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0276295",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Troy W Bishop, MD
• Amy Bissell, ATC
• Jenny Bjork, LPCC, NCC
• Heidi Kristina Black, LSW
• Lateesha Black, BS, MBA
• Tamia Blackmon
• Charles Lee Blake, RPH
• Tara Blake, COTA/L
• Patrick Blakeslee, DO
• Verlaine Blaser, DO

• Family Medicine Physician in Cuyahoga Falls, OH
• Providers in Cuyahoga Falls, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.