Individual provider Active NPI

Erin Black, NP-C

  • Family Nurse Practitioner
  • Dahlonega, GA
National Provider Identifier
1659712933
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN175357 Issued in GA
Practice address
73 Maxwell LN
Dahlonega, GA 30533-7146
Phone
(770) 219-9630
NPI assigned
Jul 15, 2013
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN175357 GA Primary

Addresses

Primary practice location

73 Maxwell LN
Dahlonega, GA 30533-7146

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

5281 Cleveland Hwy
Clermont, GA 30527-2205
Phone (770) 983-7611

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eblack30035@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140312001158 GA Practitioner - Nurse Practitioner 0345470340 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Georgia Physicians Group Urgent Care LLCGroup PAC ID 3274535687, 62 clinicians

Practice addresses (Care Compare)

2578 Helen Hwy
Cleveland, GA 30528-2848
Phone (706) 865-1234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.71
Promoting interoperability
100
Improvement activities
40
Cost
74.81

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Urgent Care LLC CurrentSince Mar 1, 2024 Accepting new patients
Northeast Georgia Physicians Group Inc CurrentSince Jan 22, 2014 Accepting new patients

Locations

1515 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 848-6195

5281 Cleveland Hwy
Clermont, GA 30527
Phone (770) 983-1611

2578 Helen Hwy
Cleveland, GA 30528
Phone (706) 865-1234

73 Maxwell Ln
Dahlonega, GA 30533
Phone (706) 344-6953

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

Interoperability endpoints

  • Direct secure messaging: eblack30035@nghs.gadirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1659712933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 MAXWELL LN",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305337146",
            "telephone_number": "770-219-9630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5281 Cleveland Hwy",
            "address_purpose": "LOCATION",
            "city": "Clermont",
            "state": "GA",
            "postal_code": "305272205",
            "country_code": "US",
            "telephone_number": "770-983-7611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ERIN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN175357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eblack30035@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5281 Cleveland Hwy",
            "city": "Clermont",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305272205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dahlonega, GA

Sources for this page

Verify at the official NPI Registry.