MR. DERRICK DWAYNE BLACK


Address: 9051 Mansfield Rd Ste E3, Shreveport, LA 71118-2680
Phone: 3187018216

MR. DERRICK DWAYNE BLACK (NPI# 1053817163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053817163
Entity Type Individual
Full Name MR. DERRICK DWAYNE BLACK
Practice Address 9051 Mansfield Rd Ste E3
Shreveport
LA 71118-2680
Practice Telephone 3187018216
Practice Fax Number 3187163378
Mailing Telephone 3184553433
Mailing Fax Number 3187163378
Enumeration Date 2018-04-05
Last Update Date 2020-06-09
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251E00000X Home Health LA Agencies

Other Provider Identifier

State Issuer Identifier Type Code
LA 822657580 05

Office Location

Street Address 9051 MANSFIELD RD STE E3
City SHREVEPORT
State LA
Zip Code 71118-2680

Providers in the same location

NPI Name Taxonomy Address Enumeration
1053936450 Five Star Elite Transportation Services LLC Non-emergency Medical Transport (VAN) 9051 Mansfield Rd Ste E3, Shreveport, LA 71118-2680 2020-06-11
1598380131 Janice Leeshal Hurks Nursing Home Administrator 9051 Mansfield Rd Ste E3, Shreveport, LA 71118-2680 2020-06-09
1205450582 Five Star Elite Home Health LLC Home Health 9051 Mansfield Rd Ste E3, Shreveport, LA 71118-2680 2020-06-03
1033752993 Fset LLC Non-emergency Medical Transport (VAN) 9051 Mansfield Rd Ste E3, Shreveport, LA 71118-2680 2019-10-23

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720620784 Wk Center for Pediatric Gastroenterology Pediatrics Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 2019-10-11
1306302443 Diamond Marie Willis Case Manager/Care Coordinator 9403 Mansfield Rd., Shreveport, LA 71118 2019-02-13
1194224469 Latosa Hall Case Manager/Care Coordinator 9007 Letha Loop, Shreveport, LA 71118 2018-02-01
1902321623 Bersheika Lashay Player Counselor 9403 Mansfield Road, Shreveport, LA 71118 2017-08-03
1518487149 Clarke Jackson Case Manager/Care Coordinator 9730 Baird Rd Apt 2310, Shreveport, LA 71118 2017-06-24
1770010449 Darrie'l Smith Counselor 2715 Mackey, Shreveport, LA 71118 2017-05-12
1760917041 Delilah Wells Case Manager/Care Coordinator 9005 Walker Rd Apt 722, Shreveport, LA 71118 2017-04-25
1790229664 We Care Transporttion Services LLC Secured Medical Transport (VAN) 2529 Summer Grove Dr, Shreveport, LA 71118 2016-12-13
1063955128 Commanisha Smith Social Worker 2715 Mackey Place, Shreveport, LA 71118 2016-11-22
1023560802 Yasmin Newman Counselor 9812 West Trails End, Shreveport, LA 71118 2016-10-27
Find all providers in zip 71118

Taxonomy Information

Taxonomy Code 251E00000X
Grouping Agencies
Classification Home Health

Taxonomy Definition

A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720626930 Loyalty Healthcare Services Home Health 2800 Youree Dr Ste 131, Shreveport, LA 71104-3667 2019-12-18
1013412253 We Care Sitting Services, LLC Home Health 2737 Mansfield Rd, Shreveport, LA 71103-3609 2018-03-29
1194220004 Empress Devion Rushing Home Health 3012 Drexel St, Shreveport, LA 71108-2016 2018-03-24
1780105908 Lhcg Cviii, LLC Home Health 1700 Buckner St Ste 200, Shreveport, LA 71101-4400 2017-06-28
1740713148 Advance Mobile Dialysis Inc. Home Health 2054 Bermuda St, Shreveport, LA 71105-3802 2017-04-04
1811344914 Professional Sitter Services Home Health 708 Milam St, Suite 202, Shreveport, LA 71101-5499 2016-05-18
1275989709 Rock Bridge Training Institute LLC Home Health 200 N Thomas Dr Ste 14, Shreveport, LA 71107-6555 2016-05-13
1063800068 Humble Heed Home Health Care Services Home Health 2701 Stanberry Dr, Shreveport, LA 71118-3252 2014-12-30
1750705299 Butler Homecare Services, LLC Home Health 2800 Youree Dr Ste 205, Shreveport, LA 71104-3667 2014-02-04
1306181680 Companion Home Services, LLC Home Health 668 Jordan, Suite B, Shreveport, LA 71101-4760 2012-11-28
Find all providers in SHREVEPORT

Competitor

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City SHREVEPORT
Zip Code 71118

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Dataset Information

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.

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