NPIMap

Individual provider Active NPI

Collin Warner Black, PA-C

  • Physician Assistant
  • Nashua, NH
National Provider Identifier
1922545888
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3217 Issued in SC
Practice address
2300 Southwood Dr
Nashua, NH 03063-1818
Phone
(603) 577-4000
Fax
(603) 640-1228
NPI assigned
Jan 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3217 SC Primary

Addresses

Primary practice location

2300 Southwood Dr
Nashua, NH 03063-1818

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Other practice location 1

96 Jonathan Lucas St
Charleston, SC 29425-3233
Phone (843) 792-3373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170530001630 TN Practitioner - Physician Assistant 3375810005 Reassigns benefits to 1 organization
I20220831002179 NH Practitioner - Physician Assistant 3375810005 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

2300 Southwood Dr
Nashua, NH 03063-1818
Phone (603) 577-4000

8 Prospect St
Nashua, NH 03060-3925
Phone (603) 577-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1845NHMDPhysical Therapist
3217SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Aug 22, 2022 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Aug 22, 2022 Accepting new patients
Vanderbilt University Medical Center CurrentSince Jul 15, 2017 Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

2300 Southwood Dr
Nashua, NH 03063
Phone (603) 577-4170

200 Strahl St
Franklin, TN 37064
Phone (615) 550-5034

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

719 Thompson Ln
Ste 30330
Nashville, TN 37204
Phone (615) 936-3871

Interoperability endpoints

  • Direct secure messaging: cblack110197@direct.dartmouth-hitchcock.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1922545888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SOUTHWOOD DR",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631818",
            "telephone_number": "603-577-4000",
            "fax_number": "603-640-1228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "96 Jonathan Lucas St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294253233",
            "country_code": "US",
            "telephone_number": "843-792-3373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "COLLIN",
        "middle_name": "WARNER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-30",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.