Active NPI
Sharla Black, BS, LMT
- Health Educator
- Salem, OR
National Provider Identifier
1821351313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 4951
- Practice address
- 4742 Liberty Rd S # 189
Salem, OR 97302-5037 - Phone
- (503) 428-8279
- NPI assigned
- Jun 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 4951 | OR | Primary |
Addresses
Primary practice location
4742 Liberty Rd S # 189
Salem, OR 97302-5037
Mailing address
4742 Liberty Rd, #189
Salem, OR 97302
Phone (503) 428-8279
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4951 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340064000000",
"number": "1821351313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4742 LIBERTY RD, #189",
"city": "SALEM",
"state": "OR",
"postal_code": "97302",
"telephone_number": "503-428-8279"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4742 LIBERTY RD S # 189",
"city": "SALEM",
"state": "OR",
"postal_code": "973025037",
"telephone_number": "503-428-8279"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "SHARLA",
"name_prefix": "Ms.",
"credential": "BS, LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-19",
"last_updated": "2012-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "OR",
"license": "4951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.