JENNIFER BLACK


Address: 583 S Clarizz Blvd, Bloomington, IN 47401-5515
Phone: 8123332663

JENNIFER BLACK (NPI# 1316173727) 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) 1316173727
Entity Type Individual
Full Name JENNIFER BLACK
Credential PA-C
Practice Address 583 S Clarizz Blvd
Bloomington
IN 47401-5515
Practice Telephone 8123332663
Enumeration Date 2009-06-01
Last Update Date 2018-11-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 10001094A IN Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
2605 E Creeks Edge Dr, Bloomington, IN 474018368 8123552300

Other Providers JENNIFER BLACK

NPI Name Taxonomy Address Enumeration
1336740786 Jennifer Lynn Black Registered Nurse 24919 S 4420 Road, Vinita, OK 74301 2020-11-03
1689172769 Jennifer Lee Black Nurse Practitioner 14509 State Route 127 Ste B, Carlyle, IL 62231-6485 2018-01-24
1508387309 Jennifer Black Assistant Behavior Analyst 5601 Arnold Rd Fl 100, Dublin, CA 94568-7726 2017-06-30
1912370354 Jennifer Black Social Worker 609 Independence Pkwy Ste 115, Chesapeake, VA 23320-5209 2015-11-06
1609263821 Jennifer Black Acupuncturist 5812 N Figueroa St, Los Angeles, CA 90042-4228 2015-04-26
1679978191 Jennifer Black Counselor 20302 Col Glenn Road, Little Rock, AR 72210 2014-10-27
1891195749 Jennifer Black Counselor 1518 Andrews Ave Ste D, Ozark, AL 36360-3716 2014-08-28
1669816500 Jennifer Black Counselor 916 Nw 42nd St, Oklahoma City, OK 73118-6805 2013-04-22
1821381096 Jennifer Black Counselor 560 Mill St Ste 250, Reno, NV 89502-1089 2011-05-20
1376872754 Jennifer A Black Massage Therapist 3809 Atrisco Dr Nw, Suite C, Albuquerque, NM 87120-4902 2009-12-15

Office Location

Street Address 583 S CLARIZZ BLVD
City BLOOMINGTON
State IN
Zip Code 47401-5515

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619958782 Jayne Crescimbeni-pierce Nurse Practitioner 583 S Clarizz Blvd, Bloomington, IN 47401-5515 2005-11-07
1407404866 Jenna Grile Registered Nurse 583 S Clarizz Blvd, Bloomington, IN 47401-5515 2019-08-29
1770038069 Supriya Kairamkonda Psychiatry & Neurology 583 S Clarizz Blvd, Bloomington, IN 47401-5515 2016-08-17
1336511591 Ryan Taylor Physical Therapist 583 S Clarizz Blvd, Bloomington, IN 47401-5515 2015-10-28
1063815389 Laurie Susan Allen Occupational Therapist 583 S Clarizz Blvd, Bloomington, IN 47401-5515 2014-10-01
1427476696 Indiana University Health Southern Indiana Physicians, Inc Durable Medical Equipment & Medical Supplies 583 S Clarizz Blvd, Bloomington, IN 47401-5515 2014-04-03
1437598596 Stephanie Danielle Van Heerden Podiatrist 583 S Clarizz Blvd, Bloomington, IN 47401-5515 2013-06-21
1477875938 Mehyar Mehrizi Psychiatry & Neurology 583 S Clarizz Blvd, Bloomington, IN 47401-5515 2010-02-24
1518198639 Gene Devane Podiatrist 583 S Clarizz Blvd, Bloomington, IN 47401-5515 2009-08-06
1932364288 Tarek Sibai Orthopaedic Surgery 583 S Clarizz Blvd, Bloomington, IN 47401-5515 2008-07-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1740765791 Holly G Carter Physical Therapist 3607 Heirloom Dr, Bloomington, IN 47401 2018-09-26
1285116657 Kimberly D Bergan Occupational Therapist 3607 S Heirloom Dr, Bloomington, IN 47401 2018-09-03
1255836813 Erin Kathleen Sain Nurse Practitioner 326 W Woodcrest Drive, Bloomington, IN 47401 2018-03-27
1881104289 Ev Bloomington Limited Partnership Assisted Living Facility 3607 South Heirloom Drive, Bloomington, IN 47401 2017-10-11
1619496536 Kirsten N Neely Physical Therapist 2604 E. Creek's Edge Dr., Bloomington, IN 47401 2017-09-12
1023533908 Hoosier United Therapy Service LLC Physical Therapist 2801 E Plateau Place, Bloomington, IN 47401 2017-08-11
1194127381 Ann Marie Neeley Lactation Consultant, Non-RN 2458 South Walnut Street, Bloomington, IN 47401 2014-09-19
1518397801 Indiana Spine and Sports Inc. Chiropractor 418 S Walnut St Suite C, Bloomington, IN 47401 2013-11-22
1053654574 William Robblee Anderson Obstetrics & Gynecology 2625 E. Spicewood Ct., Bloomington, IN 47401 2013-04-03
1285979377 Jenna Marie Dale Optometrist 322 S. Woodcrest Drive Precision Eye Group, Bloomington, IN 47401 2012-11-30
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1508496621 Samantha Jean Mcgough Lamere Physician Assistant 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 2020-01-16
1386292886 Quinn Harmon Physician Assistant 1310 W Bloomfield Rd Ste C, Bloomington, IN 47403-2001 2019-08-28
1568973717 Gregory Thomas Dougan Physician Assistant 418 South Landmark Avenue, Bloomington, IN 47403 2017-10-16
1487172409 Melody Ann Bauman Physician Assistant 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 2017-08-30
1730619487 Elise Nicole Lill Physician Assistant 4300 Market Pte Dr Ste 100, Bloomington, MN 55435-5435 2017-06-15
1528417557 Kathryn Shalbrack Physician Assistant 4300 Marketpointe Dr, Bloomington, MN 55435-5423 2016-06-09
1740634203 Alfonso Luna IIi Physician Assistant 657 S Lancewood Ave, Bloomington, CA 92316-1336 2016-04-20
1215308671 Sara Ann Houk Physician Assistant 2200 E. Washington St, Bloomington, IL 61701-4323 2015-10-12
1760865133 Patrick D Machacek Physician Assistant 10633 Vincent Ave S, Bloomington, MN 55431-3733 2015-07-03
1558740803 Samuel Johnson Physician Assistant 2901 Metro Drive, Suite 527, Bloomington, MN 55122 2015-05-20
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Competitor

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City BLOOMINGTON
Zip Code 47401

Improve Information

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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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