Active NPI
Christine Maire Black, MSN
- Pediatric Nurse Practitioner
- Georgetown, DE
National Provider Identifier
1831710458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- LJ-0000379
- Practice address
- 21141 Sterling Ave Unit 1
Georgetown, DE 19947-5571 - Phone
- (302) 856-6967
- NPI assigned
- May 5, 2020
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | LJ-0000379 | DE | Primary |
Addresses
Primary practice location
21141 Sterling Ave Unit 1
Georgetown, DE 19947-5571
Mailing address
5 Osprey LN
Middletown, DE 19709-9179
Phone (302) 883-9361
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
- Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LJ-0000379 | DE | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588636800000",
"number": "1831710458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 OSPREY LN",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "197099179",
"telephone_number": "302-883-9361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21141 STERLING AVE UNIT 1",
"city": "GEORGETOWN",
"state": "DE",
"postal_code": "199475571",
"telephone_number": "302-856-6967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "CHRISTINE",
"middle_name": "MAIRE",
"name_prefix": "Miss",
"credential": "MSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-05",
"last_updated": "2020-05-05",
"certification_date": "2020-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "DE",
"license": "LJ-0000379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.