Austin Joel Black, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06006408A Issued in IN

Practice address

8140 Township Line Rd
Indianapolis, IN 46260-5824

Phone

(317) 875-9700

NPI assigned

Nov 12, 2021

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1942966064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 KNICKERBOCKER PL APT 1D",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462402186",
            "telephone_number": "317-294-1584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 TOWNSHIP LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462605824",
            "telephone_number": "317-875-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "AUSTIN",
        "middle_name": "JOEL",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-12",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06006408A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrianna F Black, CGC
• Amber Black
• Amy Sue Black, MFT
• Antoinette Marino Black, LMFT
• Audrey Marie Black
• Babe Black, LCSW
• Candace Black
• Carla Marie Black, MD
• Dana L Black
• Elizabeth Black, NP

• Physical Therapy Assistant in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; 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.