Bertha Black

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN9375645 Issued in FL

Practice address

15420 Livingston Ave Apt 1205
Lutz, FL 33559-3419

Phone

(702) 606-4701

NPI assigned

Feb 27, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Dream Home Care Services LLC

  • Home Health Agency
  • Tampa, FL
  • NPI 1942788062
  NPD Authorized official
• Healing Hearts Nursing Services LLC

  • Registered Nurse
  • Ruskin, FL
  • NPI 1326699810
  NPD Authorized official

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1831639640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15420 LIVINGSTON AVE APT 1205",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335593419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15420 LIVINGSTON AVE APT 1205",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335593419",
            "telephone_number": "702-606-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BERTHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9375645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "623168900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Birth Center of Florida, LLC
• Birth Center of Florida, LLC
• Birthing Miracles
• Michael Lee Bishop, PH.D.
• Devan Bittinger
• Blackstone Nurse Registry LLC
• Dave W Blackwell, RPH
• Shelley Forgas Blanco, M.S., CCC/SLP
• Blessed Solutions LLC
• Bloom Pelvic Therapy LLC

• Registered Nurse in Lutz, FL
• Providers in Lutz, FL by specialty
• Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.