Mary Helen Black, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN207452 Issued in GA

Practice address

4700 Waters Ave Ste 507
Savannah, GA 31404-6220

Phone

(912) 350-7412

NPI assigned

Jun 15, 2020

Last updated

Dec 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Savannah Multispecialty Associates LLCGroup PAC ID 3678836558, 129 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Savannah Multispecialty Associates, LLC

  • Trauma Surgery Physician
  • Savannah, GA
  • NPI 1528571320
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1952926065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 DOVETAIL XING",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314199390",
            "telephone_number": "912-604-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE STE 507",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MARY",
        "middle_name": "HELEN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-15",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN207452",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "GA",
            "license": "RN207452",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BKS Home Care, LLC (Visiting Angels)
• Anna Lila Black, LPC
• Denise Michelle Black, LPC
• Harold A Black, D.D.S.
• Lashay Black
• Valerie A Black, LPN059617
• Andrea C Blackshear, LCSW, CACII, MAC
• Brandi Dawn Blackwell
• Bree Ellesse Blackwell, AUD
• Jack Thomas Blackwell Jr., MD

• Family Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.
• 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.