JENNIFER BLACK (NPI# 1316173727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1316173727 |
Entity Type | Individual |
Full Name | JENNIFER BLACK |
Credential | PA-C |
Practice Address |
583 S Clarizz Blvd Bloomington IN 47401-5515 |
Practice Telephone | 8123332663 |
Enumeration Date | 2009-06-01 |
Last Update Date | 2018-11-09 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363A00000X | Physician Assistant | 10001094A | IN | Physician Assistants & Advanced Practice Nursing Providers |
Address | Telephone Number | Fax Number |
---|---|---|
2605 E Creeks Edge Dr, Bloomington, IN 474018368 | 8123552300 |
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 |
583 S CLARIZZ BLVD |
City | BLOOMINGTON |
State | IN |
Zip Code | 47401-5515 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619958782 | Jayne Crescimbeni-pierce | Nurse Practitioner | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2005-11-07 |
1407404866 | Jenna Grile | Registered Nurse | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2019-08-29 |
1770038069 | Supriya Kairamkonda | Psychiatry & Neurology | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2016-08-17 |
1336511591 | Ryan Taylor | Physical Therapist | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2015-10-28 |
1063815389 | Laurie Susan Allen | Occupational Therapist | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2014-10-01 |
1427476696 | Indiana University Health Southern Indiana Physicians, Inc | Durable Medical Equipment & Medical Supplies | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2014-04-03 |
1437598596 | Stephanie Danielle Van Heerden | Podiatrist | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2013-06-21 |
1477875938 | Mehyar Mehrizi | Psychiatry & Neurology | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2010-02-24 |
1518198639 | Gene Devane | Podiatrist | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2009-08-06 |
1932364288 | Tarek Sibai | Orthopaedic Surgery | 583 S Clarizz Blvd, Bloomington, IN 47401-5515 | 2008-07-26 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740765791 | Holly G Carter | Physical Therapist | 3607 Heirloom Dr, Bloomington, IN 47401 | 2018-09-26 |
1285116657 | Kimberly D Bergan | Occupational Therapist | 3607 S Heirloom Dr, Bloomington, IN 47401 | 2018-09-03 |
1255836813 | Erin Kathleen Sain | Nurse Practitioner | 326 W Woodcrest Drive, Bloomington, IN 47401 | 2018-03-27 |
1881104289 | Ev Bloomington Limited Partnership | Assisted Living Facility | 3607 South Heirloom Drive, Bloomington, IN 47401 | 2017-10-11 |
1619496536 | Kirsten N Neely | Physical Therapist | 2604 E. Creek's Edge Dr., Bloomington, IN 47401 | 2017-09-12 |
1023533908 | Hoosier United Therapy Service LLC | Physical Therapist | 2801 E Plateau Place, Bloomington, IN 47401 | 2017-08-11 |
1194127381 | Ann Marie Neeley | Lactation Consultant, Non-RN | 2458 South Walnut Street, Bloomington, IN 47401 | 2014-09-19 |
1518397801 | Indiana Spine and Sports Inc. | Chiropractor | 418 S Walnut St Suite C, Bloomington, IN 47401 | 2013-11-22 |
1053654574 | William Robblee Anderson | Obstetrics & Gynecology | 2625 E. Spicewood Ct., Bloomington, IN 47401 | 2013-04-03 |
1285979377 | Jenna Marie Dale | Optometrist | 322 S. Woodcrest Drive Precision Eye Group, Bloomington, IN 47401 | 2012-11-30 |
Find all providers in zip 47401 |
Taxonomy Code | 363A00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
1386292886 | Quinn Harmon | Physician Assistant | 1310 W Bloomfield Rd Ste C, Bloomington, IN 47403-2001 | 2019-08-28 |
1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
1730619487 | Elise Nicole Lill | Physician Assistant | 4300 Market Pte Dr Ste 100, Bloomington, MN 55435-5435 | 2017-06-15 |
1528417557 | Kathryn Shalbrack | Physician Assistant | 4300 Marketpointe Dr, Bloomington, MN 55435-5423 | 2016-06-09 |
1740634203 | Alfonso Luna IIi | Physician Assistant | 657 S Lancewood Ave, Bloomington, CA 92316-1336 | 2016-04-20 |
1215308671 | Sara Ann Houk | Physician Assistant | 2200 E. Washington St, Bloomington, IL 61701-4323 | 2015-10-12 |
1760865133 | Patrick D Machacek | Physician Assistant | 10633 Vincent Ave S, Bloomington, MN 55431-3733 | 2015-07-03 |
1558740803 | Samuel Johnson | Physician Assistant | 2901 Metro Drive, Suite 527, Bloomington, MN 55122 | 2015-05-20 |
Find all providers in BLOOMINGTON |
City | BLOOMINGTON |
Zip Code | 47401 |
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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.