Active NPI
David Black, ACNP
- Adult Health Nurse Practitioner
- Concord, NC
National Provider Identifier
1831547603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 5008587
- Practice address
- 101 Cabarrus Ave E
Concord, NC 28025-3699 - Phone
- (888) 849-7379
- Fax
- (855) 857-7333
- NPI assigned
- Jun 2, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 5008587 | NC | Primary |
Addresses
Primary practice location
101 Cabarrus Ave E
Concord, NC 28025-3699
Mailing address
101 Cabarrus Ave E
Concord, NC 28025-3699
Phone (888) 849-7379
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11230 Ballantyne Trace CT
Charlotte, NC 28277-2791
Phone (704) 544-7220
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Providers of America, LLC | Current | Accepting new patients |
Locations
11230 Ballantyne Trace Ct
Charlotte, NC 28277
Phone (704) 341-1139
291 Commercial Dr
Mooresville, NC 28115
Phone (704) 663-7600
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576108800000",
"number": "1831547603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 CABARRUS AVE E",
"city": "CONCORD",
"state": "NC",
"postal_code": "280253699",
"telephone_number": "888-849-7379",
"fax_number": "855-857-7333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CABARRUS AVE E",
"city": "CONCORD",
"state": "NC",
"postal_code": "280253699",
"telephone_number": "888-849-7379",
"fax_number": "855-857-7333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "DAVID",
"name_prefix": "Mr.",
"credential": "ACNP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-02",
"last_updated": "2019-12-12",
"certification_date": "2019-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NC",
"license": "5008587",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.