Taylor Black, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13020 Issued in TN

Practice address

5505 Edmondson Pike Ste 103
Nashville, TN 37211-5869

Phone

(615) 831-1710

Fax

(615) 831-1968

NPI assigned

Feb 1, 2021

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations (25 of 31)

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.

• Star Physical Therapy LP

  • Physical Therapist
  • Nashville, TN
  • NPI 1396704094
  Medicare reassignment NPD
• Star Physical Therapy LP

  • Physical Therapist
  • Caruthersville, MO
  • NPI 1073375861
  NPD
• Star Physical Therapy LP

  • Rehabilitation Clinic/Center
  • Bolivar, TN
  • NPI 1417404351
  NPD (past)

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1972194033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681478",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681478",
            "telephone_number": "615-591-6590",
            "fax_number": "615-591-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 EDMONDSON PIKE STE 103",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372115869",
            "telephone_number": "615-831-1710",
            "fax_number": "615-831-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "TAYLOR",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "13020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0446631",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Larisa Black
• Lauren Ashley Black
• Mackenzie Black
• Mary-Kathryn Black, PH.D.
• Melissa A Black, RN
• Theodore Black, MD
• Michele Nicole Blackledge, DDS
• Gwendolyn Lefran Blackman, MS, RD, LDN
• Talisa Blackman
• Mark Blackmon, PA-C

• Physical Therapist in Nashville, TN
• Providers in Nashville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.