JENNIFER K BLACK (NPI# 1174607576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174607576 |
| Entity Type | Individual |
| Full Name | JENNIFER K BLACK |
| Other Name | JENNIFER K. LOWERS |
| Credential | N.P. |
| Practice Address |
619 E Mason St Suite 4p57 Springfield IL 62701-1034 |
| Mailing Address |
Po Box 19420 Springfield IL 62794-9420 |
| Practice Telephone | 2177880706 |
| Practice Fax Number | 2175252535 |
| Mailing Telephone | 2177880706 |
| Mailing Fax Number | 2175252535 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2019-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
209002373 | IL | Allopathic & Osteopathic Physicians |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209002373 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RAILROAD | 596500 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740786 | Jennifer Lynn Black | Registered Nurse | 24919 S 4420 Road, Vinita, OK 74301 | 2020-11-03 |
| 1689172769 | Jennifer Lee Black | Nurse Practitioner | 14509 State Route 127 Ste B, Carlyle, IL 62231-6485 | 2018-01-24 |
| 1508387309 | Jennifer Black | Assistant Behavior Analyst | 5601 Arnold Rd Fl 100, Dublin, CA 94568-7726 | 2017-06-30 |
| 1912370354 | Jennifer Black | Social Worker | 609 Independence Pkwy Ste 115, Chesapeake, VA 23320-5209 | 2015-11-06 |
| 1609263821 | Jennifer Black | Acupuncturist | 5812 N Figueroa St, Los Angeles, CA 90042-4228 | 2015-04-26 |
| 1679978191 | Jennifer Black | Counselor | 20302 Col Glenn Road, Little Rock, AR 72210 | 2014-10-27 |
| 1891195749 | Jennifer Black | Counselor | 1518 Andrews Ave Ste D, Ozark, AL 36360-3716 | 2014-08-28 |
| 1669816500 | Jennifer Black | Counselor | 916 Nw 42nd St, Oklahoma City, OK 73118-6805 | 2013-04-22 |
| 1821381096 | Jennifer Black | Counselor | 560 Mill St Ste 250, Reno, NV 89502-1089 | 2011-05-20 |
| 1376872754 | Jennifer A Black | Massage Therapist | 3809 Atrisco Dr Nw, Suite C, Albuquerque, NM 87120-4902 | 2009-12-15 |
| Street Address |
619 E MASON ST SUITE 4P57 |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62701-1034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033190814 | Carl E Arentzen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St, Suite 3p25, Springfield, IL 62701-1034 | 2005-11-09 |
| 1669913349 | Laura Grubb | Internal Medicine | 619 E Mason St, Ste. 4p57, Springfield, IL 62701-1034 | 2017-03-15 |
| 1265974604 | Julie Borjon | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2016-11-16 |
| 1912358565 | Meleah Vaughan | Nurse Practitioner | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2016-06-24 |
| 1508225616 | Margaret Jordan | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2016-02-17 |
| 1487011144 | Shauna Vogler | Internal Medicine | 619 E Mason St, Springfield, IL 62701-1034 | 2016-01-25 |
| 1871987750 | Amy Durako | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2015-03-27 |
| 1215333604 | Meredith Fleming | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2014-11-12 |
| 1154623585 | Margie Douglas | Nurse Practitioner | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2010-11-17 |
| 1326378175 | Angela K. Lafrenz | Internal Medicine | 619 E Mason St, Suite 4p57, Springfield, IL 62701-1034 | 2009-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687183 | Affinity Patient Coordination LLC | In Home Supportive Care | 217 E Monroe St Ste 102, Springfield, IL 62701 | 2018-07-31 |
| 1427498435 | Donald L Jacoby | Pharmacist | 701 N. First St., Springfield, IL 62701 | 2013-07-05 |
| 1700183480 | Erin Zepp | Dietitian, Registered | 319 E Madison St Ste 1f, Springfield, IL 62701 | 2011-02-16 |
| 1518117159 | Jyoti Assudani | Pediatrics | 301 N 8th Street, Springfield, IL 62701 | 2008-09-19 |
| 1396924148 | Jeanne Lyn Malone | Counselor | 408 South Fifth Street, Springfield, IL 62701 | 2007-10-29 |
| 1942422928 | Nobuharu Harada | Family Medicine | 301 N 8th, Pav-3a158, Springfield, IL 62701 | 2007-05-02 |
| 1427131127 | Radiological Associates of Decatur | Radiology | 319 E Madison Suite J, Springfield Mri & Imaging Center, Springfield, IL 62701 | 2006-10-24 |
| 1669498606 | Independence Holding Co LLC | Pharmacy | 201 North 5th Street, Springfield, IL 62701 | 2006-07-14 |
| 1720070238 | Neil J. Thomas | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2005-08-19 |
| 1588187397 | Andrea Nicole Bloodworth | Internal Medicine | 619 E Mason St Ste 4p57, Springfield, IL 62701 | 2017-07-24 |
| Find all providers in zip 62701 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255940060 | Rosemarie Stebbins | Nurse Practitioner | 436 Dwight St Ste 205, Springfield, MA 01103-1317 | 2020-07-28 |
| 1962906552 | Caroline Mcgarr Butler | Nurse Practitioner | 368 River St Ste 160, Springfield, VT 05156-2242 | 2018-03-20 |
| 1578070561 | Claudia Franc Williams | Nurse Practitioner | Springfield Medical Care Systems, Inc. 25 Ridgewood Rd, Springfield, VT 05156 | 2017-12-29 |
| 1598298457 | Summer Tipton | Nurse Practitioner | 2140 S Hillcrest Ave, Springfield, MO 65807-2108 | 2017-04-07 |
| 1417406489 | Amy L Peters | Nurse Practitioner | 1242 E Independence St, #200, Springfield, MO 65804-4284 | 2016-10-01 |
| 1679833271 | Sentew Care Nurse Practitioner LLC | Nurse Practitioner | 8322 Bark Tree Ct, Springfield, VA 22153-3828 | 2012-05-17 |
| 1508157140 | Springfield Internal Medicine Group | Nurse Practitioner | 1435 E Bradford Pkwy, Suite 105, Springfield, MO 65804-6563 | 2011-05-01 |
| 1043533128 | Keri Lynn Sutton | Nurse Practitioner | 1730 E Republic Rd Ste K, Springfield, MO 65804-6519 | 2010-03-03 |
| 1093967630 | Maire Alexander | Nurse Practitioner | 7939 Lake Pleasant Dr, Springfield, VA 22153-2750 | 2008-10-15 |
| 1790937498 | Marlene Karen Schmitz | Nurse Practitioner | 385 Morris Ave Ste 100, Springfield, NJ 07081-1100 | 2008-10-14 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62701 |
Please comment or provide details below to improve the information on JENNIFER K BLACK.
| 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.