DR. JASON W BLACK (NPI# 1245259902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245259902 |
| Entity Type | Individual |
| Full Name | DR. JASON W BLACK |
| Credential | M.D. |
| Practice Address |
6701 N Charles St Ste 4105 Baltimore MD 21204-6808 |
| Mailing Address |
Po Box 41895 Boston MA 02241-8953 |
| Practice Telephone | 4438493184 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2011-12-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | D61199 | MD | Allopathic & Osteopathic Physicians |
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
D61199 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | CAREFIRST REGIONAL GBMC | S1380079 | 01 |
| MD | CAREFIRST MARYLAND GBMC | KJ15/64265301 | 01 |
| MD | 405540300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841584752 | Jason Black | Counselor | 7545 Jerez Ct, Carlsbad, CA 92009-7468 | 2011-06-08 |
| 1619161676 | Jason Black | Marriage & Family Therapist | 487 Church Hill Rd Fl 2, Trumbull, CT 06611-3838 | 2007-09-04 |
| 1225221518 | Jason Black | Chiropractor | 8150 N Macarthur Blvd Ste 170, Irving, TX 75063-4314 | 2007-08-21 |
| 1275634032 | Jason Alexander Black | Dentist | 3624 N Hills Dr Ste A103, Austin, TX 78731-3061 | 2006-09-26 |
| 1073587887 | Jason A Black | Internal Medicine | 24680 Jefferson Ave, Ste A, Murrieta, CA 92562-9023 | 2006-02-16 |
| 1306217740 | Jason Allen Black | Physician Assistant | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2015-10-12 |
| 1982017232 | Jason Bruce Black | Emergency Medicine | 801 Ostrum St, Bethlehem, PA 18015-1000 | 2014-06-04 |
| 1194097022 | Jason Oliver Black | Counselor | 615 Shipyard Blvd, Wilmington, NC 28412-6431 | 2012-02-08 |
| 1508029083 | Jason L. Black | Emergency Medicine | 3109 Bienville Blvd, Department of Emergency Medicine, Ocean Springs, MS 39564-4361 | 2008-07-06 |
| 1306013305 | Jason L Black | Nurse Practitioner | 1407 W Baddour Pkwy, Lebanon, TN 37087-2513 | 2008-05-09 |
| Street Address |
6701 N CHARLES ST STE 4105 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21204-6808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033114699 | Douglas Edward Kircher | Nurse Anesthetist, Certified Registered | 6701 N Charles St, Baltimore, MD 21204-6808 | 2005-06-20 |
| 1083180327 | Louise Potter Hanssen | Nurse Practitioner | 6701 N Charles St, Baltimore, MD 21204-6808 | 2018-10-14 |
| 1568945806 | Rita Mallouh | Surgery | 6701 N Charles St, Baltimore, MD 21204-6881 | 2018-09-12 |
| 1609361880 | Margaret Craun | Occupational Therapist | 6701 N Charles St, Baltimore, MD 21204 | 2018-06-29 |
| 1639687163 | Omolara Olasimbo | Physician Assistant | 6701 N Charles St, Baltimore, MD 21204-6808 | 2018-01-18 |
| 1235640509 | Marissa Ann Kennell | Physician Assistant | 6701 N Charles St, Baltimore, MD 21204-6808 | 2017-10-13 |
| 1760907497 | Carine Marie Cattier | Physician Assistant | 6701 N Charles St, Baltimore, MD 21204-6808 | 2017-08-03 |
| 1134656408 | Sherrie Onte Oladapo | Nurse Anesthetist, Certified Registered | 6701 N Charles St, Baltimore, MD 21204-6808 | 2017-05-17 |
| 1902343825 | Kathryn Woods | Registered Nurse | 6701 N Charles St, Baltimore, MD 21204-6808 | 2017-01-30 |
| 1306382973 | Anne Parks | Physician Assistant | 6701 N Charles St, Baltimore, MD 21204-6808 | 2017-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194347575 | Sheppard Pratt Non Contracted Services, LLC | Psychiatry & Neurology | 6525 N. Charles Street, Gibson Building, Towson, MD 21204 | 2020-05-08 |
| 1578104428 | Debra James | Counselor | 6901 N. Charles Street, Towson, MD 21204 | 2019-10-02 |
| 1235696808 | Sarita Hinton | Social Worker | 300 Allegheny Ave Ste 101, Baltimore, MD 21204 | 2019-03-01 |
| 1952883159 | Peace,llc | Social Worker | 304 W. Chesapeake Ave, Towson, MD 21204 | 2018-09-04 |
| 1841772654 | Hannah Kimberly Jefferson | Acupuncturist | 7407 York Road, Towson, MD 21204 | 2018-08-29 |
| 1699255216 | Samantha Ann Rogers | Nurse Practitioner | 222 Bosley Avenue, Suite C3, Towson, MD 21204 | 2018-08-14 |
| 1750867560 | Angela Michelle Hester | Nurse Practitioner | 6525 N Charles St #085, Towson, MD 21204 | 2018-07-15 |
| 1043729098 | Communication Apptitude Inc. | Speech-Language Pathologist | 7400 York Road, Suite 231, Towson, MD 21204 | 2017-09-21 |
| 1679090203 | Brian Dougherty | Acupuncturist | 800 Kenilworth Dr, Ste# 828, Towson, MD 21204 | 2017-08-24 |
| 1659891976 | Erin Mcgovern | Specialist/Technologist | Towson Sports Medicine 8322 Bellona Ave, Suite Number 100, Baltimore, MD 21204 | 2017-06-27 |
| Find all providers in zip 21204 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| 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 Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336140524 | George Hennawi | Family Medicine | 5601 Loch Raven, Russell Morgan, Baltimore, MD 21239 | 2005-08-10 |
| 1902158678 | Bravo Health Advanced Care Center, P.C. | Family Medicine | 312 Martin Luther King Jr Blvd, Baltimore, MD 21201-1221 | 2012-10-05 |
| 1336217819 | James Paul Richardson | Family Medicine | 900 Caton Ave, Department of Medicine, Sixth Floor, Baltimore, MD 21229-5201 | 2006-12-01 |
| 1235217225 | Shari Miura Ling | Family Medicine | 3001 S Hanover St, Room Nm533, Baltimore, MD 21225-1233 | 2006-11-01 |
| 1912921453 | Karen A. Cousins | Family Medicine | 827 Linden Ave, Baltimore, MD 21201 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376735100 | Edger V Potter Jr Md Inc | Family Medicine | 12017 Fort Washington Rd, Fort Washington, MD 20744-6004 | 2007-08-15 |
| 1750595401 | Ted Eric Howe | Family Medicine | 18100 Slade School Rd, Sandy Spring, MD 20860-1313 | 2007-05-10 |
| 1265594493 | Andres Salazar | Family Medicine | 3621 Ligon Rd, Ellicott City, MD 21042-5238 | 2006-12-14 |
| 1497841563 | Farzana Ajmal | Family Medicine | 19731 Executive Park Cir, Germantown, MD 20874-2642 | 2006-10-05 |
| 1942391693 | Paul A. Devore Md PC | Family Medicine | 4203 Queensbury Rd, Hyattsville, MD 20781-1435 | 2006-09-27 |
| 1063445013 | Lifestyle Medical Center, Cheryl Brown-christopher M. D., Chartered | Family Medicine | 116 Defense Hwy Ste 200, Annapolis, MD 21401-7045 | 2006-07-09 |
| 1932135548 | Nagji J Sureja | Family Medicine | 4212 Ridge Rd, Westminster, MD 21157-7849 | 2006-06-24 |
| 1689612236 | Raman Tuli, Md, P.C. | Family Medicine | 10810 Darnestown Rd, Suite 202, Gaithersburg, MD 20878-2675 | 2006-06-04 |
| 1851346423 | Arvind D Desai | Family Medicine | 30 Corporate Center, 10440 Little Patuxent Parkway, Suite 300, Columbia, MD 21044-3648 | 2006-05-23 |
| 1134102775 | Cyrus Hamidi | Family Medicine | 913 Ridgebrook Rd, Suite 312, Sparks, MD 21152-9451 | 2005-11-29 |
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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.