Eyanna Thompson Black, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F06232152 Issued in NC

Practice address

3734 Reynolda Rd
Winston Salem, NC 27106-2240

Phone

(336) 922-1102

NPI assigned

Jul 10, 2023

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: eyanna.black.1@6378.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/6378/brand/1/csg/1/fhir/r4

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.

• Ardmore Family Practice P.a.

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1750342820
  NPD

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1891473864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3734 REYNOLDA RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271062240",
            "telephone_number": "336-922-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3734 REYNOLDA RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271062240",
            "telephone_number": "336-922-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "EYANNA",
        "middle_name": "THOMPSON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F06232152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda L Bitting, M.D.
• Keela Bittle
• Erhan Biyikli
• Christan Shadeene Black, AGNP-BC
• Chue Lee Black, PHARM D, CPP
• Joel A Black Jr., DDS
• Kimberley Alyson Black
• Nickolas S Black
• Perrin Jefferson Black, D.D.S
• Tammy Kinney Black, RPH

• Family Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.