David Allen Black, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001856 Issued in IA

Practice address

609 SE Kent St
Greenfield, IA 50849-9454

Phone

(641) 743-2123

NPI assigned

Feb 4, 2008

Last updated

Sep 14, 2012By 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 IA

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

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adair County Memorial HospitalGroup PAC ID 3072403153, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adair County Memorial Hospital Hospital, Greenfield, IA, CCN 161310
• Guthrie County Hospital Hospital, Guthrie Center, IA, CCN 161314
• Community Care Center Nursing home, Stuart, IA, CCN 165501

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/f904b187-16a4-4582-8ea3-887d87de0011/

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.

• Adair County Memorial Hospital

  dba Adair County Memorial Hospital ER Group

  • Emergency Medicine Physician
  • Greenfield, IA
  • NPI 1366531345
  Medicare reassignment Care Compare group NPD
• Adair County Memorial Hospital

  • Critical Access Hospital
  • Greenfield, IA
  • NPI 1780667519
  Medicare reassignment
• Adair County Memorial Hospital

  dba Adair County Home Care

  • Public Health or Welfare Agency
  • Greenfield, IA
  • NPI 1285614818
  NPD
• Story County Hospital

  dba Nevada Medical Clinic

  • Family Medicine Physician
  • Nevada, IA
  • NPI 1023080504
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adair County Memorial Hospital

  • Critical Access Hospital
  • Greenfield, IA
  • NPI 1780667519
  Care Compare affiliation
• Community Care Center Inc

  dba Community Care Center

  • Skilled Nursing Facility
  • Stuart, IA
  • NPI 1699768630

  Nursing home

  Care Compare affiliation
• Guthrie County Hospital

  • Critical Access Hospital
  • Guthrie Center, IA
  • NPI 1366414534
  Care Compare affiliation

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347580800000",
    "number": "1801074794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 SE KENT ST",
            "city": "GREENFIELD",
            "state": "IA",
            "postal_code": "508499454",
            "telephone_number": "641-743-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 SE KENT ST",
            "city": "GREENFIELD",
            "state": "IA",
            "postal_code": "508499454",
            "telephone_number": "641-743-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-04",
        "last_updated": "2012-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "001856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adair County Memorial Hospital
• Adair County Memorial Hospital (Adair County Memorial Hospital NP Group)
• Adair County Memorial Hospital (Adair County Memorial Hospital Waiver)
• Adair County Mental Health, Inc
• Ambermed, LLC
• Marvel Jean Blazek, ARNP
• Care Initiatives (Care Initiatives Hospice - Greenfield)
• Brittany Christoffersen
• County of Adair
• Jenna Evans, PA-C

• Physician Assistant in Greenfield, IA
• Providers in Greenfield, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.