Individual provider Active NPI

Arica Grace Black, AUD

  • Audiologist
  • Lubbock, TX
National Provider Identifier
1871938639
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
80592 Issued in TX
Practice address
5607 114TH St
Suite 100
Lubbock, TX 79424
Phone
(806) 798-3600
NPI assigned
May 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 80592 TX Primary

Addresses

Primary practice location

5607 114TH St
Suite 100
Lubbock, TX 79424

Mailing address

4819 119TH PL
Lubbock, TX 79424-6179
Phone (281) 733-7679

Other names 1

  • Arica Grace Worthington Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130924000055 TX Practitioner - Qualified Audiologist 5991949455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Texas Audiology and Hearing Aid CenterGroup PAC ID 9234484064, 3 clinicians

Practice addresses (Care Compare)

5607 114TH St
Suite 100
Lubbock, TX 79424-7007
Phone (806) 798-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
80592TXMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Audiology and Hearing Aid Center Audiologist CurrentSince Apr 9, 2018 Accepting new patients

Locations

5607 114th St
Ste 100
Lubbock, TX 79424
Phone (806) 798-3600

4505 82nd St
Ste 8
Lubbock, TX 79424
Phone (806) 797-9550

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": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1871938639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4819 119TH PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794246179",
            "telephone_number": "281-733-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5607 114TH ST",
            "address_2": "SUITE 100",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79424",
            "telephone_number": "806-798-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ARICA",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2021-11-04",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ARICA",
            "last_name": "WORTHINGTON",
            "middle_name": "GRACE",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.