Active NPI
Stephanie Black
- Critical Care Medicine Registered Nurse
- Creedmoor, NC
National Provider Identifier
1972902773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 209094
- Practice address
- 1979 Bowles Ave
Creedmoor, NC 27522-7824 - Phone
- (919) 529-4530
- NPI assigned
- Aug 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 209094 | NC | Primary |
Addresses
Primary practice location
1979 Bowles Ave
Creedmoor, NC 27522-7824
Mailing address
1979 Bowles Ave
Creedmoor, NC 27522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209094 | NC | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408320000000",
"number": "1972902773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1979 BOWLES AVE",
"city": "CREEDMOOR",
"state": "NC",
"postal_code": "27522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1979 BOWLES AVE",
"city": "CREEDMOOR",
"state": "NC",
"postal_code": "275227824",
"telephone_number": "919-529-4530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "STEPHANIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-18",
"last_updated": "2014-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "NC",
"license": "209094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Creedmoor, NC
- Benjamin Koren, D.D.S. III. P.a,
- Meldrina A. Bernard
- Yvonne E Berstler, MD
- Best Care Pharmacy of Creedmoor, L.L.C.
- Bip - Behavior Intervention Professionals of the Triangle, PLLC
- Bonding Lives Home Care Agency Inc
- Catherina Bostelman, M.D.
- Kristen Hall Bounds, LMFT
- Heather Nicole Bowers, RD
- Brothers Community Resources
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.