SCOTT ALLEN BLACK (NPI# 1720284706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720284706 |
| Entity Type | Individual |
| Full Name | SCOTT ALLEN BLACK |
| Credential | RD |
| Practice Address |
2200 Bergquist Dr Ste 1 Lackland A F B TX 78236-9908 |
| Mailing Address |
2200 Bergquist Drive, Suite 1, Attn Credentials Cmc Lackland Afb TX 78236-5300 |
| Practice Telephone | 2102926707 |
| Mailing Telephone | 2102927964 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811257462 | Scott Bayles Black | Family Medicine | 51600 Huntington Rd, La Pine, OR 97739-8887 | 2012-05-16 |
| 1205899978 | Scott Jeffrey Black | Physical Therapist | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2006-04-11 |
| Street Address |
2200 BERGQUIST DR STE 1 |
| City | LACKLAND A F B |
| State | TX |
| Zip Code | 78236-9908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467891366 | Samantha Luanne Guy | Physician Assistant | 2200 Bergquist Dr Ste 1, Attn: Credentials (sghc), Lackland A F B, TX 78236-9908 | 2013-06-24 |
| 1427492545 | Oscar Escano | General Practice | 2200 Bergquist Dr Ste 1, 59 Mhs/sgowv1, Lackland A F B, TX 78236-9908 | 2013-04-19 |
| 1881935112 | J T Floyd | Physician Assistant | 2200 Bergquist Dr Ste 1, Attn: Credentials (sghc), Lackland A F B, TX 78236-9908 | 2013-03-12 |
| 1144583352 | Cleann Toner | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2012-06-21 |
| 1417223561 | Nancy Vogelgesang | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2012-03-22 |
| 1295011641 | Stephen Garrett Ray | Nurse Practitioner | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2011-10-31 |
| 1396029559 | Daniel Sung Oh | Military Health Care Provider | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2011-10-06 |
| 1184919763 | Marley Cranford Smith | Case Manager/Care Coordinator | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2011-06-13 |
| 1770881633 | Jennifer B Gillespie | Student in an Organized Health Care Education/Training Program | 2200 Bergquist Dr Ste 1, Lackland A F B, TX 78236-9908 | 2011-03-02 |
| 1972804540 | Nilofer N Pervez Arthur | Pharmacist | 2200 Bergquist Dr Ste 1, Lackland Air Force Base, Lackland A F B, TX 78236-9908 | 2010-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477755098 | Tammy Jane Lindberg | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Attn Credentials (cmc), Lackland A F B, TX 78236-9908 | 2007-06-05 |
| 1689700528 | Sharon Melissa Hunter | Dietitian, Registered | 2200 Bergquist Dr, Suite 1, Lackland A F B, TX 78236-9907 | 2007-02-26 |
| 1659441921 | Craig Andrew Olson | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Attn Credentials (cmc), Lackland A F B, TX 78236-9908 | 2006-11-08 |
| 1275611337 | Catherine Bullard | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2006-11-02 |
| 1528099819 | Kristina Kuhl | Dietitian, Registered | 2200 Bergquist Dr Ste 1, Attn: Credentials (cmc), Lackland A F B, TX 78236-9908 | 2006-07-05 |
| 1316977549 | Tanya Crail | Dietitian, Registered | 2200 Bergquist Dr, Ste 1, Lackland A F B, TX 78236-9907 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902637 | Allison Kleppe | Dietitian, Registered | 6255 Oram St Apt 106, Dallas, TX 75214-3985 | 2020-11-08 |
| 1326649088 | Mitzie Rojas | Dietitian, Registered | 1805 Aquarena Springs Dr Apt 505, San Marcos, TX 78666-8164 | 2020-11-07 |
| 1912507971 | Wendy Snowden | Dietitian, Registered | 11223 Kingsgate Dr, Austin, TX 78748-3435 | 2020-10-29 |
| 1720687718 | Jordan Wright | Dietitian, Registered | 2900 N Braeswood Blvd Apt 6204, Houston, TX 77025-2367 | 2020-10-20 |
| 1891393062 | Melanie Thomas | Dietitian, Registered | 4722 Pickridge Ct, Fresno, TX 77545-7529 | 2020-10-11 |
| 1073110318 | Mary Elizabeth Santarosa Mahoney | Dietitian, Registered | 1322 Cotulla Dr, Allen, TX 75013-4639 | 2020-10-08 |
| 1104423797 | Mariam Maaz Eid | Dietitian, Registered | 8421 Etienne Cv, Austin, TX 78759-8201 | 2020-10-06 |
| 1518564467 | Elizabeth Hill | Dietitian, Registered | 6500 Champion Grandview Way Apt 22105, Austin, TX 78750-8388 | 2020-10-05 |
| 1215534441 | Maryia Nassonova | Dietitian, Registered | 5740 Airport Fwy, Haltom City, TX 76117-6005 | 2020-10-01 |
| 1366049488 | Ifunanya Onyima | Dietitian, Registered | 2500 Marketplace Dr Apt 536, Waco, TX 76711-2440 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | LACKLAND A F B |
| Zip Code | 78236 |
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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.