Kathryn F Black, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103325 Issued in NC

Practice address

1025 Medical Center Drive
Wilmington, NC 28401

Phone

(910) 341-1886

Fax

(910) 343-6019

NPI assigned

Mar 2, 2007

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Delaney Radiologists Group PLLC

  • Specialist
  • Wilmington, NC
  • NPI 1912982166
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1790813459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 JACOBS CREEK LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284093012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MEDICAL CENTER DRIVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28401",
            "telephone_number": "910-341-1886",
            "fax_number": "910-343-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KATHRYN",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Henry Black IV, D.O.
• Jason Oliver Black, L.P.A., L.C.A.S
• Jenna E Black, MD
• John Alexander Black, M.D.
• Katelyn Carluzzo Black
• Melissa Whitesell Black, CNM
• Charles T Blackburn, CRNA
• Linda Blackburn, RPH
• Siara Southerland Blackburn
• Thomas L Blackstone, MD

• Physician Assistant in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.