Henry Campbell McNaughton Black

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-12600 Issued in NC

Practice address

3031 New Bern Ave Ste 306
Raleigh, NC 27610-2989

Phone

(919) 876-7807

NPI assigned

Sep 30, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Duke University School of Medicine, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Summit Eye Care PAGroup PAC ID 9133270283, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Summit Eye Care, P.a.

  • Ophthalmology Physician
  • Winston Salem, NC
  • NPI 1992932016
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1821712175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 NEW BERN AVE STE 306",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102989",
            "telephone_number": "919-876-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 NEW BERN AVE STE 306",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102989",
            "telephone_number": "919-876-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "HENRY",
        "middle_name": "CAMPBELL MCNAUGHTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-30",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ncnephrologyassociates@directaddress.net",
            "affiliation": "N",
            "address_1": "3031 New Bern Ave Ste 306",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276102989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• BKD Personal Assistance Services LLC
• BKSS Fitness LLC
• Alexandra Black, NURSE PRACTITIONER
• Destini Black
• Haylie Black
• Julia Black, MS
• Megan Kathleen Black, MSN, APRN, AGNP-C
• Taylor Winn Black, PA-C
• Tammy Blackard Cook, LCSW
• Jeffrey Robert Blackburn, MD

• Physician Assistant in Raleigh, NC
• Providers in Raleigh, 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 Jun 9, 2023; 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.