Organization Active NPI

Erin Black, MD PLLC

  • Clinic/Center
  • Gainesville, FL
National Provider Identifier
1649924630
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ERIN BLACK, MD PLLC
Practice address
6801 NW 9TH Blvd Ste 2
Gainesville, FL 32605-4263
Phone
(352) 514-5829
NPI assigned
Feb 8, 2022
Last updated
Feb 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Dr. Erin Black, M.D.NPI 1831419068
Title
Owner
Phone
(352) 514-5829

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

6801 NW 9TH Blvd Ste 2
Gainesville, FL 32605-4263

Mailing address

5408 SW 93Rd Ter
Gainesville, FL 32608-4327
Phone (352) 514-5829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220312000157 FL Part B Supplier - Clinic/Group Practice 3072908946 Receives reassigned benefits from 1 practitioner
Practice locations: Gainesville, FL

National Provider Directory

National Provider Directory

Locations

6801 NW 9th Blvd
Ste 2
Gainesville, FL 32605
Phone (352) 331-3401

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1649924630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5408 SW 93RD TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084327",
            "telephone_number": "352-514-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 NW 9TH BLVD STE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054263",
            "telephone_number": "352-514-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIN BLACK, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-514-5829",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.