MRS. IVA L BLACK (NPI# 1053511956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053511956 |
| Entity Type | Individual |
| Full Name | MRS. IVA L BLACK |
| Practice Address |
1016 Sw D Ave Lawton OK 73501 |
| Mailing Address |
1016 Sw D Ave Mercer Beauty Supply Lawton OK 73501 |
| Practice Telephone | 5803530690 |
| Mailing Telephone | 5803530690 |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
22498 | OK | Other Service Providers |
| Street Address |
1016 SW D AVE |
| City | LAWTON |
| State | OK |
| Zip Code | 73501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053506121 | Mercer Beauty Supply | Orthotic Fitter | 1016 Sw D Ave, Lawton, OK 73501 | 2007-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811596729 | Alyssa K Manfredi | Speech-Language Pathologist | 1700 Nw Lee Blvd, Lawton, OK 73501 | 2020-10-21 |
| 1295079705 | Premier Behavorial Health | Community/Behavioral Health | 2305 Southwest H Avenue, Suite #1, Lawton, OK 73501 | 2012-11-21 |
| 1306156989 | Diana Nix | Licensed Practical Nurse | 611 Sw B Ave, Lawton, OK 73501 | 2010-10-15 |
| 1689993214 | Crystal Leday | Physical Therapy Assistant | 602 S.e. Wallock, Lawton, OK 73501 | 2010-05-21 |
| 1457679862 | Gary Dean Gardner | Dentist | 1301 West Gore Blvd, Suite 2, Lawton, OK 73501 | 2010-05-10 |
| 1962729848 | Tayler Gammon | Hearing Instrument Specialist | 423 S.w. C Ave, Lawton, OK 73501 | 2010-04-30 |
| 1932430725 | Eric B Carpenter Sr. | Counselor | 807 Sw F Avenue, Lawton, OK 73501 | 2010-01-19 |
| 1447487640 | Benjamin Llanos | Counselor | 1719 Sw 11th, Lawton, OK 73501 | 2009-06-15 |
| 1710122833 | Provide Hearing Aids | Public Health or Welfare | 1201 West Gore Blvd, Suite D, Lawton, OK 73501 | 2008-12-03 |
| 1528273604 | Harlan L Ross Jr. | Counselor | 1719 S.w. 11th, Lawton, OK 73501 | 2007-05-11 |
| Find all providers in zip 73501 | ||||
| Taxonomy Code | 1744P3200X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| Specialization | Prosthetics Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952915902 | Courtney Robinson | Specialist | 5436 S Mingo Rd Ste B, Tulsa, OK 74146-5740 | 2020-09-06 |
| 1578065710 | Tanisha L Mitchell | Specialist | 3209 S Broadway Ste 117, Edmond, OK 73013-4062 | 2018-03-04 |
| 1255768727 | Roslyn Richelle Franklin | Specialist | 525 E 5th St, Okmulgee, OK 74447-4045 | 2013-09-30 |
| 1811296981 | Billy Joe Wilkerson Jr. | Specialist | 16105 Cattail Circle, Edmond, OK 73013 | 2011-03-15 |
| 1851496871 | Rita S Bibles | Specialist | 4917 Amherst Dr, Bartlesville, OK 74006-8504 | 2006-09-14 |
| 1053413039 | Anthony Quin Pannell Jr. | Specialist | 221 W Franklin Ave Apt 4, Weatherford, OK 73096-4849 | 2006-09-01 |
| 1255979514 | Debrisha Sharlett Boykins | Specialist | 101 Park Ave Ste 1300, Oklahoma City, OK 73102-7216 | 2019-12-18 |
| 1447782339 | Tony Thottukadavil | Specialist | 4207 W Memorial Rd, Oklahoma City, OK 73134 | 2017-03-30 |
| 1346491750 | Robert Hendon Ward IIi | Specialist | 921 Ne 13th St, Prosthetics Rm 1b100, Oklahoma City, OK 73104-5007 | 2008-10-03 |
| 1457447450 | Silhouettes | Specialist | 4917 Amherst Dr, Bartlesville, OK 74006-8504 | 2006-10-05 |
| Find all providers with the same taxonomy | ||||
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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.