NPIMap

Individual provider Active NPI

Caitlin Black, MD

  • Internal Medicine Physician
  • Huntingdon, TN
National Provider Identifier
1710568522
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
75393 Issued in TN
Practice address
631 RB Wilson Dr
Huntingdon, TN 38344-1727
Phone
(731) 986-4461
NPI assigned
Apr 14, 2021
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 75393 TN
Internal Medicine Physician 207R00000X 75393 TN Primary

Addresses

Primary practice location

631 RB Wilson Dr
Huntingdon, TN 38344-1727

Mailing address

910 Madison Ave FL 2
Memphis, TN 38103-3403

Other practice location 1

920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone (901) 448-7635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260305001569 TN Practitioner - Internal MedicinePractitioner - Emergency Medicine 1557761186 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medical Care Facilities PCGroup PAC ID 6103837877, 57 clinicians

Practice addresses (Care Compare)

650 Nuckolls Rd
Bolivar, TN 38008-1532
Phone (731) 658-3100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75393TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC Internal Medicine CurrentSince Apr 1, 2026 Accepting new patients
Hospital Medicine Services of Tennessee PC Internal Medicine CurrentSince Feb 20, 2026 Accepting new patients
Emergency Medical Care Facilities PC Emergency Medicine CurrentSince Jan 18, 2026 Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135

631 Rb Wilson Dr
Huntingdon, TN 38344
Phone (731) 986-2933

367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

5959 Park Ave
Memphis, TN 38119
Phone (901) 765-1000

4039 Highland St
Ste 1
Milan, TN 38358
Phone (731) 723-3668

Organizations & group practices 3

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 5

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": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1710568522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 MADISON AVE FL 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381033403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 RB WILSON DR",
            "city": "HUNTINGDON",
            "state": "TN",
            "postal_code": "383441727",
            "telephone_number": "731-986-4461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Madison Ave Ste 447",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033438",
            "country_code": "US",
            "telephone_number": "901-448-7635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "CAITLIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-14",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "75393",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "75393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntingdon, TN

Sources for this page

Verify at the official NPI Registry.