MR. COLLIN SHEFFIELD BLACK (NPI# 1659905032) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659905032 |
Entity Type | Individual |
Full Name | MR. COLLIN SHEFFIELD BLACK |
Credential | MD |
Practice Address |
109 Mayfield Cir Durham NC 27705-6136 |
Practice Telephone | 8014719422 |
Enumeration Date | 2020-02-25 |
Last Update Date | 2020-02-25 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 171000000X | Military Health Care Provider | Other Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922545888 | Collin Warner Black | Physician Assistant | 96 Jonathan Lucas St, Charleston, SC 29425-3233 | 2017-01-30 |
Street Address |
109 MAYFIELD CIR |
City | DURHAM |
State | NC |
Zip Code | 27705-6136 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
Find all providers in zip 27705 |
Taxonomy Code | 171000000X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
Notes: [7/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740459361 | Demetris Devane Mcleod | Military Health Care Provider | 508 Fulton St # 117c, Durham, NC 27705-3875 | 2008-02-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699338442 | Amanda Leigh Jepsen | Military Health Care Provider | Naval Medical Center; 100 Brewster Blvd, Camp Lejeune, NC 28547 | 2019-04-17 |
1578058194 | Dwain Gavin Mccall | Military Health Care Provider | C1722 Tagaytay Drive, Fort Bragg, NC 28310-5318 | 2018-06-26 |
1346747011 | Rachel Eden Leigh Palmer | Military Health Care Provider | 2803 Medical Campus Dr, Seymour Johnson Afb, NC 27531 | 2018-04-10 |
1881198182 | Orleiquis Guerra | Military Health Care Provider | Marine Corps Air Station New River Bldg As-100, Jacksonville, NC 28540 | 2018-03-21 |
1720530355 | Robert Holly | Military Health Care Provider | 7606 Reilly Rd, Bldg 2, Fort Bragg, NC 28307 | 2016-10-31 |
1912322694 | Christopher W Clark | Military Health Care Provider | G544 C Street, Camp Lejuene, NC 28542 | 2014-03-04 |
1326296641 | Scott Durham Mitcham | Military Health Care Provider | Command Drive, Building 328, Camp Lejeune, NC 28542 | 2008-08-28 |
1194885442 | Dynela Louise Garcia-baran | Military Health Care Provider | 2168 Brandymill Ln, Jacksonville, NC 28546 | 2006-12-09 |
1174581235 | Cross Creek Urgent Care and Family Clinic | Military Health Care Provider | 726 Ramsey St, Suite 8, Fayetteville, NC 28301-4705 | 2006-05-01 |
1669452389 | Michael James Harrison | Military Health Care Provider | Department Anesthesia Naval Hospital Cherry Point, Mcas Cherry Point, Havelock, NC 28533 | 2006-01-19 |
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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.