DR. MELISSA PHILLIPS BLACK (NPI# 1376767483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376767483 |
| Entity Type | Individual |
| Full Name | DR. MELISSA PHILLIPS BLACK |
| Other Name | DR. MELISSA MARIE PHILLIPS |
| Credential | M.D. |
| Practice Address |
1365 Clifton Rd Ne Atlanta GA 30322-1013 |
| Practice Telephone | 4047286363 |
| Practice Fax Number | 4047286298 |
| Mailing Telephone | 4047286363 |
| Mailing Fax Number | 4047286298 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2012-07-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
056266 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073631149 | Melissa Olson Black | Specialist/Technologist | 3250 River Road West, Goochland, VA 23063 | 2007-03-27 |
| 1457301921 | Melissa L Black | Optometrist | 1435 E Venice Ave, Suite 110, Venice, FL 34292-3074 | 2006-05-12 |
| 1013538834 | Melissa Margo Black | Registered Nurse | 1215 E Michigan Ave, Lansing, MI 48912-1811 | 2020-05-04 |
| 1144853706 | Melissa Black | Behavior Technician | 7001 W 79th St, Overland Park, KS 66204-3179 | 2020-02-21 |
| 1023652500 | Melissa Lee Black | Counselor | 860 Lynn St, Lebanon, MO 65536-3810 | 2019-10-29 |
| 1225686132 | Melissa M Black | Social Worker | 9150 Sw 87th Ave Ste B100, Miami, FL 33176-2311 | 2019-09-04 |
| 1083195903 | Melissa Black | Developmental Therapist | 9000 S County Road 800 W, Daleville, IN 47334-9420 | 2018-08-28 |
| 1821507757 | Melissa Black | Social Worker | 2212 Hope Mills Rd, Fayetteville, NC 28304-4228 | 2017-09-22 |
| 1982140141 | Melissa Black | Pharmacist | 2046 Ne Waldo Rd, Suite 3100, Gainesville, FL 32609-8975 | 2017-01-12 |
| 1043505993 | Melissa Black | Physical Therapist | 1000 Carondelet Dr, Kansas City, MO 64114-4673 | 2011-06-17 |
| Street Address |
1365 CLIFTON RD NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30322-1013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124022637 | Richard Duszak Jr. | Radiology | 1365 Clifton Rd Ne, Emory University Department of Radiology, Atlanta, GA 30322-1013 | 2005-06-13 |
| 1891319091 | Kayla Sondria Freeman | Registered Nurse | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-06-03 |
| 1548881576 | Rachelle Leona Rouse | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-04-30 |
| 1982233227 | Kayla Anne Nichols | Pharmacist | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-04-08 |
| 1326675380 | Tankeia Tanye' Warren | Nurse Practitioner | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-03-26 |
| 1407488687 | Bethany Joan Hanscom | Physician Assistant | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2020-02-06 |
| 1518505577 | Juanjuan Wu | Nurse Practitioner | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2019-12-20 |
| 1942847587 | Nour Majed Moukalled | Internal Medicine | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2019-12-02 |
| 1528604816 | Tram Bao Vu | Physician Assistant | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2019-11-21 |
| 1083266845 | Desiree Morgan Rogers | Nurse Practitioner | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2019-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445830 | Justin Gill | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne, Clinic B - Suite B6100, Atlanta, GA 30322 | 2019-06-12 |
| 1891354510 | Gwendolyn Gisiner Gunn | Genetic Counselor, MS | Emory Genetics Clinic, 1365 Clifton Road Ne, Atlanta, GA 30322 | 2019-06-06 |
| 1144710567 | Lisa Cathy-ann Akosa | Registered Nurse | 1365 Cifton Road Ne, Atlanta, GA 30322 | 2018-05-10 |
| 1083118004 | Jessica Milian Keilson | Student in an Organized Health Care Education/Training Program | 1364 Clifton Road Ne, Suite H100, Emory University Hospital Office of Surgical Education, Atlanta, GA 30322 | 2018-03-23 |
| 1568982684 | Jennifer Bilko | Dietitian, Registered | 1365 Clifton Rd., Bldg A, 1st Floor, Suite 1450, Atlanta, GA 30322 | 2017-06-20 |
| 1134652258 | Kassahun Bilcha | Student in an Organized Health Care Education/Training Program | 1525 Clifton Rd Ne Ste 100, Atlanta, GA 30322 | 2017-04-05 |
| 1356872246 | Tova Rogers | Dermatology | 1525 Clifton Road Suite 105, Atlanta, GA 30322 | 2017-03-23 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1427404904 | Rita Kaur Kuwahara | Student in an Organized Health Care Education/Training Program | 100 Woodruff Circle, Suite 327, Atlanta, GA 30322 | 2016-05-13 |
| 1891176251 | Octav Cristea | Transplant Surgery | 1365 Clifton Road Northeast, Building B, 6th Floor, Atlanta, GA 30322 | 2015-06-11 |
| Find all providers in zip 30322 | ||||
| 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 |
|---|---|---|---|---|
| 1043442080 | Sam Peng Md PC | Family Medicine | 1622 Rivergreen Bnd Se, Atlanta, GA 30339-8546 | 2009-08-10 |
| 1649690967 | Emily Nance Mason | Family Medicine | 35 Collier Rd Nw Ste 635, Atlanta, GA 30309-1611 | 2014-04-25 |
| 1427268101 | Sahebi A Saiyed | Family Medicine | 1841 Clifton Rd Ne, Atlanta, GA 30329-4021 | 2007-05-23 |
| 1033241666 | Friendship Community Healthcare Inc | Family Medicine | 430 Centennial Olympic Park Dr Nw, Atlanta, GA 30313-2203 | 2007-03-09 |
| 1598860595 | Monica Willis Parker | Family Medicine | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2006-09-14 |
| 1558476937 | Carole S Gardner | Family Medicine | 3495 Piedmont Road Ne, Medical Offices Administration, Atlanta, GA 30305 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295366292 | B Mata LLC | Family Medicine | 1631 Atlanta Hwy, Gainesville, GA 30504-5942 | 2020-01-28 |
| 1558916056 | Newtown Park Medical Clinic and Geriatrics LLC | Family Medicine | 2880 Old Alabama Rd #300, Johns Creek, GA 30022-5033 | 2019-08-02 |
| 1558830919 | Patriot Healthcare of Georgia, LLC | Family Medicine | 833 Hairston Road, Stone Mountain, GA 30083 | 2018-11-15 |
| 1275002636 | Patriot Healthcare of Georgia, LLC | Family Medicine | 1587 Phoenix Boulevard, Suite 6, College Park, GA 30349 | 2018-11-15 |
| 1215471479 | Deana Perkins | Family Medicine | 756 Arrowhead Lake Rd, Thomaston, GA 30286-5004 | 2016-12-07 |
| 1255731741 | Jafar Tabatabai M.d. P.C. | Family Medicine | 7961 Highway 92 Ste 100, Woodstock, GA 30189-5209 | 2014-09-03 |
| 1457604381 | Senior Care Plus Limited Liability Company | Family Medicine | 990 Peachtree Industrial Blvd Number 4532, Suwanee, GA 30024-5249 | 2012-10-16 |
| 1053662296 | Community Primary Care of Georgia LLC | Family Medicine | 946 Veterans Pkwy, Barnesville, GA 30204-3771 | 2012-09-27 |
| 1669770954 | J&a Wood, LLC | Family Medicine | 2724 Grey Fox Ct, Haddock, GA 31033-6009 | 2011-03-10 |
| 1134259369 | Rina Eisenstein | Family Medicine | 215 Arbor Creek Way, Roswell, GA 30076-1291 | 2007-03-06 |
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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.