DR. PATRICK MICAL BLACK (NPI# 1306179528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306179528 |
| Entity Type | Individual |
| Full Name | DR. PATRICK MICAL BLACK |
| Credential | PHARMD |
| Practice Address |
2410 Fire Mesa St Las Vegas NV 89128-9016 |
| Practice Telephone | 7026366320 |
| Mailing Telephone | 7026366320 |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2009-09-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
15081 | NV | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750537080 | Patrick Armando Black | Chiropractor | 195 El Camino Real Ste. 202, Tustin, CA 92780 | 2008-08-18 |
| 1326439159 | Patrick T Black | Physical Therapist | 1676 E 6th St, Beaumont, CA 92223-5760 | 2015-02-16 |
| Street Address |
2410 FIRE MESA ST |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89128-9016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447238258 | Amy Ellwood | Social Worker | 2410 Fire Mesa St, #180, Family Practice Center, Las Vegas, NV 89128-9016 | 2006-01-03 |
| 1235664020 | Betty Omandac | Nurse Practitioner | 2410 Fire Mesa St, Suite 160, Las Vegas, NV 89128-9016 | 2017-04-28 |
| 1851822969 | Hannah Hosotani | Student in an Organized Health Care Education/Training Program | 2410 Fire Mesa St, Suite 180, Las Vegas, NV 89128-9016 | 2017-03-22 |
| 1164953097 | David Masuck | Student in an Organized Health Care Education/Training Program | 2410 Fire Mesa St, Suite 180, Las Vegas, NV 89128-9016 | 2017-03-22 |
| 1750741740 | Genesis Wound Care of Las Vegas, LLC | Podiatrist | 2410 Fire Mesa St, Suite 160, Las Vegas, NV 89128-9016 | 2016-03-03 |
| 1366838567 | Hind Elsanousy | Family Medicine | 2410 Fire Mesa St, Suite 180, Las Vegas, NV 89128-9016 | 2015-04-14 |
| 1588058044 | Rajiv Jeyakumar Ganesan | Family Medicine | 2410 Fire Mesa St, Suite 180, Las Vegas, NV 89128 | 2015-03-23 |
| 1720472376 | Kathy Lao | Student in an Organized Health Care Education/Training Program | 2410 Fire Mesa St, Suite 180, Las Vegas, NV 89128-9016 | 2015-03-21 |
| 1487071825 | Harsh Patel | Student in an Organized Health Care Education/Training Program | 2410 Fire Mesa St, Suite 180, Las Vegas, NV 89128-9016 | 2014-03-24 |
| 1164864963 | Anthony V Borgia Dpm Pllc | Podiatrist | 2410 Fire Mesa St, Ste 160, Las Vegas, NV 89128-9016 | 2013-07-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374256 | Dmc Medical Clinic Ltd | Family Medicine | 7140 Smoke Ranch Road, 150, Las Vegas, NV 89128 | 2020-10-23 |
| 1619589462 | Eldercare Services Lv, LLC | Technician | 8430 W. Lake Mead Blvd Suite 100, Las Vegas, NV 89128 | 2020-08-21 |
| 1508477308 | Amneris Lizet Duran-brocato | Technician | 1150 North Buffalo Dr. Apt 2120, Las Vegas, NV 89128 | 2020-08-14 |
| 1366082612 | Ar Home Health Management LLC | Home Health | 7465 W Lake Mead Blvd Suite 100, Las Vegas, NV 89128 | 2020-01-14 |
| 1114563731 | Leslie A Pasternack | Acupuncturist | Integrated Acupuncture of Southern Nevada, 7250 Peak Dr #106, Las Vegas, NV 89128 | 2019-11-19 |
| 1154977940 | Devora Susana Leon-lopez | Chore Provider | 7320 Smoke Ranch Rd. Ste. H, Las Vegas, NV 89128 | 2019-08-16 |
| 1659924884 | Blanca Estela Garnica-mendez | Chore Provider | 7320 Smoke Ranch Rd. Suite H, Suite H, Las Vegas, NV 89128 | 2019-07-17 |
| 1467913160 | Sherwin Necunazar Azad | Student in an Organized Health Care Education/Training Program | Mountainview Hospital Gme, 3100 N. Tenaya Way, Las Vegas, NV 89128 | 2019-03-26 |
| 1962963801 | Michael Richard Korczynski | Student in an Organized Health Care Education/Training Program | 3100 North Tenaya Way, Las Vegas, NV 89128 | 2019-03-25 |
| 1013477041 | Yuanlong Zhao | Student in an Organized Health Care Education/Training Program | 3100 N Tenaya Way Graduate Medical Education, Las Vegas, NV 89128 | 2019-03-25 |
| Find all providers in zip 89128 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619599149 | Michael Choi | Pharmacist | 312 Lorelei Rock St # 31, Las Vegas, NV 89138-3015 | 2020-05-06 |
| 1598394959 | Gena Martelli Melnik V | Pharmacist | 9530 Ruperts Ct, Las Vegas, NV 89123-6214 | 2020-04-07 |
| 1003448333 | Shirley Lauren Valenzona-gianan | Pharmacist | Smith's Pharmacy #318, 4965 East Sahara Avenue, Las Vegas, NV 89104 | 2020-02-05 |
| 1295393601 | United Medical Group Pllc | Pharmacist | 9205 W. Russell Road, Building 3, Ste 240, Las Vegas, NV 89148 | 2019-05-31 |
| 1972067650 | Alanna Kaiwi | Pharmacist | 4370 S Grand Canyon Dr Apt 1080, Las Vegas, NV 89147-7112 | 2019-01-26 |
| 1043719719 | Don Nguyen Le | Pharmacist | 9940 Antelope Canyon Ave, Las Vegas, NV 89147-7713 | 2018-02-07 |
| 1396260907 | Leana Marie Ramirez | Pharmacist | 701 Shadow Ln Ste 110, Las Vegas, NV 89106-4132 | 2017-08-04 |
| 1053713982 | Jennifer Reeves | Pharmacist | 3912 Pasilla Ave, Las Vegas, NV 89118-0561 | 2014-09-23 |
| 1053727834 | Yui Hong Tang | Pharmacist | 216 Fortress Course Ct, Las Vegas, NV 89148-2508 | 2014-07-01 |
| 1689929234 | Bruce M Thielke | Pharmacist | 11752 San Rosarita Ct, Las Vegas, NV 89138-6022 | 2012-07-19 |
| Find all providers in LAS VEGAS | ||||
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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.