MRS. NEICOLE DUTTON BLACK (NPI# 1033158548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033158548 |
| Entity Type | Individual |
| Full Name | MRS. NEICOLE DUTTON BLACK |
| Other Name | MRS. NEICOLE BLACK |
| Credential | PA-C |
| Practice Address |
2410 Hoffmeyer Rd Florence SC 29501-7311 |
| Mailing Address |
60 Commerce Plaza Cir Pembroke NC 28372-7386 |
| Practice Telephone | 8438826162 |
| Practice Fax Number | 8436628183 |
| Mailing Telephone | 9105212900 |
| Mailing Fax Number | 9107759165 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 1091 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
1091 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8103286 | 05 | |
| SC | STATE LICENSE NUMBER | 1091 | 01 |
| Street Address |
2410 HOFFMEYER RD |
| City | FLORENCE |
| State | SC |
| Zip Code | 29501-7311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588058507 | Cynthia J. Gainey | Nurse Practitioner | 2410 Hoffmeyer Rd, Florence, SC 29501-7311 | 2015-03-27 |
| 1255753919 | Merry Beth Knierim | Nurse Practitioner | 2410 Hoffmeyer Rd, Florence, SC 29501-7311 | 2014-01-15 |
| 1780923672 | Doctors Care Sc, Pa | Emergency Medicine | 2410 Hoffmeyer Rd, Florence, SC 29501-7311 | 2013-02-12 |
| 1235413360 | Elizabeth Maxwell Knippen | Physician Assistant | 2410 Hoffmeyer Rd, Florence, SC 29501-7311 | 2011-10-07 |
| 1093745895 | Lorrie D. Peyton | Nurse Practitioner | 2410 Hoffmeyer Rd, Florence, SC 29501-7311 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700350444 | Angel Edwards Brown | Nurse Practitioner | Mcleod Health, 555 East Cheves Street, Florence, SC 29501 | 2019-01-16 |
| 1497229124 | Fred L. Evans IIi | Physical Therapy Assistant | 2439 Willwood Dr., Florence, SC 29501 | 2019-01-16 |
| 1841715596 | Faith Hope Love Homecare | Home Health | 604 S. Coit Street, Florence, SC 29501 | 2017-08-03 |
| 1083156350 | Karen Artis-bacote | Nurse Practitioner | 3835 Susan Dr, Florence, SC 29501 | 2016-11-17 |
| 1992251581 | Higher Ground Christian Counseling Service, LLC | Counselor | 1801 D West Evans Street, Florence, SC 29501 | 2016-09-01 |
| 1952752818 | Jack Carter Shackelford | Chiropractor | 311 West Palmetto Street, Florence, SC 29501 | 2016-06-22 |
| 1750743506 | Profection Therapy LLC | Clinic/Center | 315d North Beltline Dr., Florence, SC 29501 | 2016-03-22 |
| 1386002467 | Bergelt Optometric LLC | Optometrist | 2672 David Mcleod Blvd, Florence, SC 29501 | 2016-02-04 |
| 1437531993 | Sherika Tarshall Stuckey | Nurse Practitioner | 720 Coventry Lane, Apt C, Florence, SC 29501 | 2015-06-22 |
| 1245610062 | Christopher Tyree | Podiatrist | 709 W Evans St, Florence, SC 29501 | 2015-06-06 |
| Find all providers in zip 29501 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931283 | Sterling Simmons Capotosti | Physician Assistant | 1813 Joseph Cir, Florence, SC 29501-6339 | 2020-10-28 |
| 1922625185 | Michael O'brien | Physician Assistant | 70 Acrebrook Dr, Florence, MA 01062-3421 | 2020-07-02 |
| 1669099677 | Brittany Nicole Rafferty | Physician Assistant | 903 Schisler Dr, Florence, NJ 08518-2803 | 2020-06-26 |
| 1669013744 | Marissa Lisette Cadena | Physician Assistant | 16305 Highland Dr, Florence, MT 59833-6068 | 2019-09-30 |
| 1538715784 | Jeffre Rogers Mccutcheon | Physician Assistant | 200 W Evans St, Florence, SC 29501-3469 | 2019-08-14 |
| 1992272470 | Hope Lee | Physician Assistant | 800 E Cheves Street Ste 350, Florence, SC 29506-4765 | 2018-11-01 |
| 1982062642 | Andrew Coleman | Physician Assistant | 205 Marengo St., Eliza Coffee Memorial Hospital, Florence, AL 35636 | 2016-02-09 |
| 1619352259 | Jordan Mcclure | Physician Assistant | 7683 Mall Rd Unit B, Florence, KY 41042-1590 | 2015-07-24 |
| 1134460561 | Julie Marie Clement | Physician Assistant | 971 Jason Lopez Cir Stop B, Florence, AZ 85132-2502 | 2013-03-11 |
| 1740359314 | Kevin Hall | Physician Assistant | 660 South Main Street, Florence, AZ 85232 | 2006-11-07 |
| Find all providers in FLORENCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.