Daniel C Black, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PT2018-017 Issued in AR

Practice address

603 N Progress Ave
Siloam Springs, AR 72761-4352

Phone

(479) 524-4141

Fax

(479) 549-2577

NPI assigned

Mar 27, 2018

Last updated

Mar 28, 2018By 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

Medicare fee-for-service enrollment

Enrolled in AR

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

Physician Assistant

State licenses

Practice roles

Locations

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.

• South Arkansas Emergency Physicians LLP

  • Emergency Medicine Physician
  • El Dorado, AR
  • NPI 1942435458
  Medicare reassignment
• Ies Arkansas PLLC

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1598488090

  AR

  Medicare reassignment
• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  AR

  Medicare reassignment
• South Arkansas Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Siloam Springs, AR
  • NPI 1225452055

  Physician Assistant

  NPD
• South Arkansas Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Bentonville, AR
  • NPI 1447671490

  Physician Assistant

  NPD

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1699270140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 N PROGRESS AVE",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727614352",
            "telephone_number": "479-524-4141",
            "fax_number": "479-549-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DANIEL",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PT2018-017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bill Pickard, DDS, Ms, PA (Arkansas Orthodontics)
• Billingsley Eye Clinic
• Janet Susan Bilyeu, NURSE PRACTITIONER
• Holly Doran Bingham, ATC
• Josh Biswell, CMT
• Michelle I Blackfox
• Abigail Faelon Bliss, LAC
• Annie E Boehme
• Sarah Bohon
• Lauren Grace Bonge

• Physician Assistant in Siloam Springs, AR
• Providers in Siloam Springs, AR by specialty
• Physician Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.