Kelly Black

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

675500 Issued in TX

Practice address

7100 W 9TH Ave
Amarillo, TX 79106-1704

Phone

(806) 212-0247

NPI assigned

Oct 1, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Patriot AnesthesiaGroup PAC ID 6608139308, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Patriot Anesthesia

  • Certified Registered Nurse Anesthetist
  • Arlington, TX
  • NPI 1720589310

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Emergenchealth PLLC

  • Anesthesiology Physician
  • Fort Worth, TX
  • NPI 1467970897

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Northstar Anesthesia, PA

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1912978610

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Texas Anesthesia Partners, PLLC

  • Anesthesiology Physician
  • Southlake, TX
  • NPI 1144673468
  Medicare reassignment NPD

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1881928299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5327 N CENTRAL EXPY",
            "address_2": "STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752053345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 W 9TH AVE",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061704",
            "telephone_number": "806-212-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "KELLY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-01",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "675500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Black & Ruiz Dental Centre, Inc.
• Blaire Black
• Danny Earl Black, DMD
• Jeanna D'Ann Black, MED, LPC
• Jeff Black
• Kenneth Bryan Black, REGISTERED NURSE
• Lauren Black
• Shelly Black, COTA/CLT
• April Lynn Blackwell, RN
• Courtney B Blackwell, RN, MSN, AGNP AANP-C

• Certified Registered Nurse Anesthetist in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Certified Registered Nurse Anesthetist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; 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.