Dawn Michelle Black, APRN FNP-C ACHPN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704213611 Issued in MI

Practice address

2372 Kronner Rd
Columbus, MI 48063-3404

Phone

(810) 300-0323

NPI assigned

Nov 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dblack366017@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Henry Ford Health System

  • Nurse Practitioner
  • Detroit, MI
  • NPI 1104900455
  Medicare reassignment
• Region VII Area Agency on Aging Inc

  • PACE Provider Organization
  • Fort Gratiot, MI
  • NPI 1477654127

  Nurse Practitioner

  NPD
• Henry Ford Health System

  • Community Based Hospice Care Agency
  • Detroit, MI
  • NPI 1427081694
  NPD (past)
• Henry Ford Maplegrove Center

  • Children's Substance Abuse Rehabilitation Facility
  • West Bloomfield, MI
  • NPI 1295767630
  NPD (past)
• MMS Audiology LLC

  • Audiologist
  • Bingham Farms, MI
  • NPI 1467937862
  NPD (past)

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

{
    "created_epoch": "1510358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1669985792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2372 KRONNER RD",
            "city": "COLUMBUS",
            "state": "MI",
            "postal_code": "480633404",
            "telephone_number": "810-300-0323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2372 KRONNER RD",
            "city": "COLUMBUS",
            "state": "MI",
            "postal_code": "480633404",
            "telephone_number": "810-300-0323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5229 Lakeshore Rd",
            "address_purpose": "LOCATION",
            "city": "Fort Gratiot",
            "state": "MI",
            "postal_code": "480593122",
            "country_code": "US",
            "telephone_number": "810-388-6300 x618",
            "fax_number": "810-388-6305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Ford Pl Ste 4C",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482023450",
            "country_code": "US",
            "telephone_number": "313-874-6500 x3948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33464 Schoenherr Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483126319",
            "country_code": "US",
            "telephone_number": "586-276-9500",
            "fax_number": "586-276-9510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DAWN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "APRN FNP-C ACHPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-11",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704213611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Allen Coney, M.A., LLP
• Victoria Lynn Davis, LPN
• Gentle Birthing in Southeast Michigan, LLC
• Trish Greenia, R.N.
• Thomas James Iskra, OTR

• Family Nurse Practitioner in Columbus, MI
• Providers in Columbus, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.