Daniel Lawrence Black, MSN, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP137811 Issued in TX

Practice address

1400 W SW Loop 323 Ste 60
Tyler, TX 75701-7059

Phone

(903) 526-4875

NPI assigned

Jun 22, 2018

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1912492927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W ERWIN ST STE B",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757027227",
            "telephone_number": "830-708-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W SW LOOP 323 STE 60",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757017059",
            "telephone_number": "903-526-4875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 W Erwin St Ste B",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757027227",
            "country_code": "US",
            "telephone_number": "830-708-2135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DANIEL",
        "middle_name": "LAWRENCE",
        "credential": "MSN, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP137811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ann Bishop, MS
• Rachel B Bizot, PA
• Rebekah Bjorklund, MD
• Aladrian Black
• Alice Seavon Black, OPTHALMIC ASSISTANT
• Mikayla Black, OTR/L
• Omega Black
• Ty Brandon Black, DDS
• Melodie Marian Blackmon, DO
• Bridgett Blackshire

• Nurse Practitioner in Tyler, TX
• Providers in Tyler, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.