MITCHELL C. BLACK (NPI# 1104083021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104083021 |
| Entity Type | Individual |
| Full Name | MITCHELL C. BLACK |
| Credential | M.D. |
| Practice Address |
3643 N Roxboro St Durham NC 27704-2702 |
| Mailing Address |
2301 Erwin Rd Durham NC 27705-4699 |
| Practice Telephone | 9194708490 |
| Mailing Telephone | 9199704175 |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2010-05-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 2010-00846 | NC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 142044 | NC | Student, Health Care |
| Street Address |
3643 N ROXBORO ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27704-2702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033113899 | Nirmish Shah | Internal Medicine | 3643 N Roxboro St, Durham, NC 27704-2702 | 2005-06-09 |
| 1548872633 | Christopher James Rogge | Nurse Anesthetist, Certified Registered | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-08-19 |
| 1801404579 | Grace L Johnson | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-07-20 |
| 1174147102 | Kaitlyn Elizabeth Cockerham | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-06-05 |
| 1306466859 | Keri Laurelle Konstant | Registered Nurse | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-04-24 |
| 1194351262 | Deidre Pelletier | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-03-20 |
| 1720618812 | Elizabeth Parker Sulentic | Nurse Practitioner | 3643 N Roxboro St, Durham, NC 27704-2702 | 2020-01-17 |
| 1265079131 | Melinda Yvonne House | Nurse Practitioner | 3643 N Roxboro St, Durham, NC 27704-2702 | 2019-12-10 |
| 1427607811 | Grace Amy Revenaugh Dreyer | Physician Assistant | 3643 N Roxboro St, Durham, NC 27704-2702 | 2019-09-09 |
| 1841848934 | Ann Mei Lin | Hospitalist | 3643 N Roxboro St, Durham, NC 27704-2702 | 2019-08-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723139 | Devang Ashokbhai Patel | Dentist | 2609 N Duke St Ste 618, Durham, NC 27704 | 2018-06-14 |
| 1891201042 | Little Family Care Home, LLC | Custodial Care Facility | 1012 Davinci Street, Durham, NC 27704 | 2017-12-26 |
| 1033625702 | Tondra A Little | Social Worker | 2804 Nellowood Street, Durham, NC 27704 | 2017-12-18 |
| 1437502408 | Jhazmere Shamas Preston | Counselor | 2609 N. Duke St. Suite 403, Durham, NC 27704 | 2016-07-14 |
| 1649626656 | Professional Elevations Pllc | Case Manager/Care Coordinator | 304 Crutchfield Drive, Durham, NC 27704 | 2016-05-09 |
| 1083071617 | Alyssa Wilson | Speech-Language Pathologist | 215 William Penn Plz Apt 908, Durham, NC 27704 | 2016-01-27 |
| 1932565124 | Arthur Reynolds Jr and Associates P.l.l.c. | Dentist | 2106 N Duke St, Durham, NC 27704 | 2016-01-05 |
| 1962877720 | Chimere Brooks | Contractor | 4001meriwether Drive Apt P-19, Durham, NC 27704 | 2015-12-04 |
| 1184013294 | Danielle King | Physician Assistant | 3611 N Duke Street, Durham, NC 27704 | 2015-01-13 |
| 1730581901 | Images, 'of Me To You' | Community/Behavioral Health | 2823 Cascadilla Street, Durham, NC 27704 | 2014-09-19 |
| Find all providers in zip 27704 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578077780 | Linda Heskestad Harpole | Internal Medicine | 3475 Erwin Rd Ste 200, Durham, NC 27705-0005 | 2017-11-27 |
| 1932629136 | Solomiia Savedchuk | Internal Medicine | 1000 Mcqueen Dr Apt 10102, Durham, NC 27705-8842 | 2017-06-20 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1497141097 | Myung Woo | Internal Medicine | Duke University Hospital 40 Duke Medicine Circle, Durham, NC 27710 | 2015-04-09 |
| 1750701918 | Lana Wahid | Internal Medicine | 40 Duke Medicine Cir # 3534, Durham, NC 27710-4000 | 2014-04-25 |
| 1962822742 | Zachary Hager | Internal Medicine | 40 Medicine Circle Duke University Medical Center 3534, Durham, NC 27710-4872 | 2014-04-21 |
| 1316383243 | Nastassia Jennae Schenkel | Internal Medicine | Duke Primary Care Pickett Road, 3004 Tower Blvd, Durham, NC 27707 | 2013-05-19 |
| 1114360799 | James Stanley Howard | Internal Medicine | 2301 Erwin Rd Ste 1151, Durham, NC 27705 | 2013-04-12 |
| 1053651695 | John Morrison Macgregor | Internal Medicine | 92 Dover Rd, Durham, NH 03824-3318 | 2013-02-19 |
| 1649527714 | Duke University Affiliated Physicians, Inc. | Internal Medicine | 4020 Roxboro Rd, Durham, NC 27704 | 2012-08-08 |
| Find all providers in DURHAM | ||||
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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.