Active NPI
James D Black, DPM
- Podiatrist
- Rochester Hills, MI
National Provider Identifier
1649265232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- JB001105
- Practice address
- 101 Rochdale Dr S
Suite C
Rochester Hills, MI 48309-2273 - Phone
- (248) 652-3400
- Fax
- (248) 652-3401
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | JB001105 | MI | Primary |
| Durable Medical Equipment & Medical Supplies | 332B00000X | JB001105 | MI |
Addresses
Primary practice location
101 Rochdale Dr S
Suite C
Rochester Hills, MI 48309-2273
Mailing address
101 Rochdale Dr S
Suite C
Rochester Hills, MI 48309-2273
Phone (248) 652-3400
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0731430001 | Other | MI | DME - SUPPLIES, EQUIPMENT |
| 1626185 | Medicaid | MI | |
| 382583434 | Other | FEDERAL ID | |
| 5635035 | Other | MI | PTAN |
| 485635035 | Other | BLUE CROSS BLUE SHIELD MICHIGAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JB001105 | MI | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337817600000",
"number": "1649265232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 ROCHDALE DR S",
"address_2": "SUITE C",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483092273",
"telephone_number": "248-652-3400",
"fax_number": "248-652-3401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 ROCHDALE DR S",
"address_2": "SUITE C",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483092273",
"telephone_number": "248-652-3400",
"fax_number": "248-652-3401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "JAMES",
"middle_name": "D",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2012-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MI",
"license": "JB001105",
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "MI",
"license": "JB001105",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DME - SUPPLIES, EQUIPMENT",
"identifier": "0731430001",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1626185",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL ID",
"identifier": "382583434",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "5635035",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MICHIGAN",
"identifier": "485635035",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.