Gary Chase Black, M.D.
Individual provider Active NPI Pain Medicine (Anesthesiology) Physician · Dayton, TN
NPI 1700149648 · NPPES record last updated Jun 1, 2018
Key facts
- NPI
- 1700149648
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pain Medicine (Anesthesiology) Physician 207LP2900X
- License
- 55829 (TN)
- Practice address
- 9400 Rhea County Hwy
Dayton, TN 37321 - Phone
- (423) 285-5220
- Fax
- (423) 285-5506
- NPI assigned
- Jun 15, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pain Management Group LLC
Practice addresses (Care Compare)
9400 Rhea County Hwy
Dayton, TN 37321-7922
Phone (423) 285-5220
Hospital & facility affiliations
- Rhea Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 75.6 of 100
- Quality
- 75.56
- Improvement activities
- 40
- Cost
- 59.98
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171023002932 | TN | Practitioner - Anesthesiology | 1850680976 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55829 | TN | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pain Management Group LLC | Current |
Accepting new patients | |
| Medical University of South Carolina | Past | Accepting new patients | |
| Pain Management Group PLLC | Past | Accepting new patients |
Locations
123 E Crawford St
Findlay, OH 45840
9400 Rhea County Hwy
Dayton, TN 37321
Phone (423) 285-5220
9400 Rhea County Hwy
Ste 200
Dayton, TN 37321
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EDFGBD/Endpoint/EDFGBD
- gary.black@rmctr.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | LL34886 | SC | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 55829 | TN | Yes |
Addresses
Primary practice location
9400 Rhea County Hwy
Dayton, TN 37321
Mailing address
167 Ashley Ave
Suite 301, MSC 912
Charleston, SC 29425-9120
Phone (843) 792-0192
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T00148A | Other | TN | MEDICARE PTAN |
| Q029957 | Medicaid | TN |
Other providers in Dayton, TN
- Tonya Barnwell
- Chelsea Beddoe
- Benchmark Healthcare Services LLC
- Kindall Billingsley
- Michael John Birdwell
- Faith Blackmon
- Erica Blair
- Shayla Lynne Bogga
- Thomas P. Bovine
- Stacy Gose Bowers
All providers in Dayton, TN · Pain Medicine (Anesthesiology) Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.