MR. TREVOR ELAN BLACK (NPI# 1861835308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861835308 |
| Entity Type | Individual |
| Full Name | MR. TREVOR ELAN BLACK |
| Credential | D.P.M. |
| Practice Address |
20 Glenlake Parkway Kaiser Permanente Glenlake Medical Center Atlanta GA 30328 |
| Mailing Address |
3495 Piedmont Road, Ne Nine Piedmont Center Atlanta GA 30305 |
| Practice Telephone | 8183261058 |
| Mailing Telephone | 4045045678 |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2016-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
POD001289 | GA | Podiatric Medicine & Surgery Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780838631 | Trevor Edward Black | Emergency Medicine | 100 Park St, Glens Falls, NY 12801-4413 | 2008-11-05 |
| Street Address |
20 GLENLAKE PARKWAY KAISER PERMANENTE GLENLAKE MEDICAL CENTER |
| City | ATLANTA |
| State | GA |
| Zip Code | 30328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528063781 | Jeffrey B Crowder | Ophthalmology | 20 Glenlake Parkway, Kaiser Permanente Glenlake Medical Center, Atlanta, GA 30328 | 2005-06-15 |
| 1659712883 | Karen Whelchel Shaw | Physician Assistant | 20 Glenlake Parkway, Kaiser Permanente Glenlake Medical Center, Atlanta, GA 30328 | 2013-07-16 |
| 1932549185 | Ashley Dykes Griffin | Physician Assistant | 20 Glenlake Parkway, Kaiser Permanente Glenlake Medical Center, Atlanta, GA 30328 | 2013-07-02 |
| 1326485327 | Andrena Niles Woodhams | Optometrist | 20 Glenlake Parkway, Kaiser Permanente Glenlake Medical Center, Atlanta, GA 30328 | 2013-05-30 |
| 1023300308 | Mary W. Algeo | Technician, Other | 20 Glenlake Parkway, Kaiser Permanente Glenlake Medical Center, Atlanta, GA 30328 | 2011-05-05 |
| 1073819371 | Cheryl Sue Arnson | Audiologist | 20 Glenlake Parkway, Kaiser Permanente Glenlake Medical Center, Atlanta, GA 30328 | 2011-02-03 |
| 1245536655 | Valerie Ann Ochs | Advanced Practice Midwife | 20 Glenlake Parkway, Kaiser Permanente Glenlake Medical Center, Atlanta, GA 30328 | 2011-02-02 |
| 1780816785 | Kara Shea Thompson | Nurse Practitioner | 20 Glenlake Parkway, Glenlake Medical Office-dept. of Cardiology, Atlanta, GA 30328 | 2009-08-10 |
| 1437386307 | Zaneta Danette Romain | Urology | 20 Glenlake Parkway, Kaiser Permanente Glenlake Medical Center, Atlanta, GA 30328 | 2009-06-17 |
| 1598907925 | Anthonia D Adewole | Surgery | 20 Glenlake Parkway, Kaiser Permanente Glenlake Medical Center, Atlanta, GA 30328 | 2009-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467910042 | Amber Andrews | Behavior Technician | 750 Hammond Drive Bldg 7 Suite 100, Atlanta, GA 30328 | 2019-03-04 |
| 1215492830 | Ryan William Dubinin | Behavior Technician | 750 Hammond Drive, Building 7, Suite 100, Atlanta, NJ 30328 | 2019-02-07 |
| 1346710142 | Emily Rose Lloyd Swavely | Speech-Language Pathologist | 5825 Glenridge Rd., Building 1, Suite 133, Atlanta, GA 30328 | 2018-12-05 |
| 1063994481 | Mark Edward Brachmanski | Optometrist | 800 Mount Vernon Highway Ne, Suite 130, Atlanta, GA 30328 | 2018-09-01 |
| 1407352578 | Nina Brown | Massage Therapist | 7100 Peachtree Dunwoody Rd Ste 110, Sandy Springs, GA 30328 | 2018-04-05 |
| 1336657741 | Renee Usher Reeves | Assistant Behavior Analyst | 750 Hammond Dr Building 7, Suite 100, Atlanta, GA 30328 | 2018-01-19 |
| 1487168274 | Patricia Nicole Felder | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr, Ne, Suite # 400, Atlanta, GA 30328 | 2017-12-01 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1770093601 | Syed M Rasheed | Physician Assistant | 5788 Roswell Rd Ste 100, Atlanta, GA 30328 | 2017-10-05 |
| 1437678190 | Jeanette Denise Jones | Counselor | 270 Carpenter Drive, Suite 400, Sandy Springs, GA 30328 | 2017-09-13 |
| Find all providers in zip 30328 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1891228540 | Vishal Patel | Podiatrist | 755 Mount Vernon Hwy Ne Ste 210, Atlanta, GA 30328-4279 | 2017-04-10 |
| 1013322742 | A. Louis Jimenez D.p.m. PC | Podiatrist | 1150 Hammond Dr Bldg E, Suite 600, Atlanta, GA 30328-5334 | 2014-06-20 |
| 1104183086 | Krum Georgiev | Podiatrist | 3193 Howell Mill Rd Nw Ste 326, Atlanta, GA 30327-2100 | 2012-04-18 |
| 1255642609 | Erinn Nicole Ponder | Podiatrist | 275 Carpenter Dr, # 106, Atlanta, GA 30328-4928 | 2010-06-30 |
| 1538492962 | Bednarz Foot and Ankle Pllc | Podiatrist | 107 Peachtree Hills Ave Ne, Atlanta, GA 30305-4303 | 2009-09-17 |
| 1427229475 | Affiliated Foot and Ankle, P.C. | Podiatrist | 3025 Maple Dr Ne Ste 2, Atlanta, GA 30305-2618 | 2008-03-18 |
| 1467644880 | Focus Foot & Ankle Centers, LLC | Podiatrist | 5491 Roswell Rd Ne, Suite B, Atlanta, GA 30342-1911 | 2007-08-10 |
| 1831179886 | Annette D. Filiatrault | Podiatrist | 3025 Maple Dr Ne, Suite 2, Atlanta, GA 30305-2618 | 2006-01-17 |
| 1174143770 | Affiliated Foot and Ankle, P.C. | Podiatrist | 619 Rankin St Ne, Atlanta, GA 30308-2920 | 2020-04-23 |
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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.