Individual provider Active NPI

Karen Elena Black, RN

  • Community Health Registered Nurse
  • Detroit, MI
National Provider Identifier
1861602286
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
4704229788 Issued in MI
Practice address
6309 Mack Ave
Detroit, MI 48207-2302
Phone
(313) 424-0390
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 4704229788 MI Primary

Addresses

Primary practice location

6309 Mack Ave
Detroit, MI 48207-2302

Mailing address

18674 Rutherford St
Detroit, MI 48235-2942
Phone (313) 870-0013

Other practice location 1

1151 Taylor Street 246-A
Detroit Health Dept Communicable Disease Division
Detroit, MI 48202-1732
Phone (313) 870-0013

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704229788MIMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1861602286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18674 RUTHERFORD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352942",
            "telephone_number": "313-870-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-424-0390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1151 Taylor Street 246-A",
            "address_2": "Detroit Health Dept Communicable Disease Division",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482021732",
            "country_code": "US",
            "telephone_number": "313-870-0013",
            "fax_number": "313-876-4532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KAREN",
        "middle_name": "ELENA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "MI",
            "license": "4704229788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.