THOMAS BLACK (NPI# 1619346376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619346376 |
| Entity Type | Individual |
| Full Name | THOMAS BLACK |
| Credential | NP |
| Practice Address |
111 W Hobbs St Roswell NM 88203-1869 |
| Mailing Address |
2727 N Wilshire Blvd Roswell NM 88201-6691 |
| Practice Telephone | 5756233311 |
| Practice Fax Number | 5756221273 |
| Mailing Telephone | 5756233311 |
| Mailing Fax Number | 5756221273 |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2016-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | A141627 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851474167 | Thomas Houston Black IIi | Family Medicine | 1145 Indianapolis Road, Greencastle, IN 46135 | 2006-10-23 |
| 1932687407 | Thomas Harrison Black | Peer Specialist | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2018-08-06 |
| 1942559463 | Thomas Robert Black Jr. | Clinical Exercise Physiologist | 168 Denslow Rd, East Longmeadow, MA 01028-3188 | 2012-08-30 |
| 1265600266 | Thomas Short Black | Speech-Language Pathologist | Berkeley County Board of Education, 401 South Queen Street, Martinsburg, WV 25401 | 2008-02-13 |
| 1982808796 | Thomas Daniel Black | Emergency Medicine | 8686 New Trails Dr, # 100, The Woodlands, TX 77381-1176 | 2007-06-14 |
| 1417078122 | Thomas C Black | Nurse Practitioner | 800 Howard Ave, Yale Physicians Bldg, New Haven, CT 06519-1369 | 2007-04-02 |
| 1689691180 | Thomas C Black | Ophthalmology | 1010 Carondelet Dr, Suite 103, Kansas City, MO 64114-4821 | 2006-07-17 |
| 1427017805 | Thomas J Black | Radiology | 10000 Bay Pines Blvd, Bay Pines Vamc, Bay Pines, FL 33744 | 2006-03-22 |
| 1508838871 | Thomas Black | Pediatrics | 219 Bryant Street, Buffalo, NY 14222-2006 | 2006-02-02 |
| Street Address |
111 W HOBBS ST |
| City | ROSWELL |
| State | NM |
| Zip Code | 88203-1869 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093778839 | Jane Marie Gilbreth | Family Medicine | 111 W Hobbs St, Roswell, NM 88203-1869 | 2006-04-11 |
| 1184233132 | Tracy Nicholle Bell | Registered Nurse | 111 W Hobbs St, Roswell, NM 88203-1869 | 2020-07-27 |
| 1528603602 | Amy Lynn Wishard | Nurse Practitioner | 111 W Hobbs St, Roswell, NM 88203-1869 | 2019-11-12 |
| 1093282246 | Rachel M Schupp | Nurse Practitioner | 111 W Hobbs St, Roswell, NM 88203-1869 | 2018-10-25 |
| 1285119651 | Jennifer May | Nurse Practitioner | 111 W Hobbs St, Roswell, NM 88203-1869 | 2018-10-01 |
| 1114445590 | Mark Amba Standley | Physician Assistant | 111 W Hobbs St, Roswell, NM 88203-1869 | 2017-09-06 |
| 1629145792 | Kelley Pharmacy | Pharmacy | 111 W Hobbs St, Roswell, NM 88203-1869 | 2006-11-30 |
| 1487688792 | Jo Ann Whiteman | Family Medicine | 111 W Hobbs St, Roswell, NM 88203-1869 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770115586 | Katherine Bolin | Behavior Technician | 333 West Brasher Rd. #200, Roswell, NM 88203 | 2020-02-10 |
| 1437660040 | Pecos Valley Eye Surgery Center, LLC | Clinic/Center | 1610 Se Main Street, Roswell, NM 88203 | 2017-10-23 |
| 1285031286 | Wheelchair and Walker Rentals, Inc. | Durable Medical Equipment & Medical Supplies | 305 W Mcgaffey St, Roswell, NM 88203 | 2014-11-20 |
| 1447585914 | Whole World Health Care, PC | Pediatrics | 109 W. Bland, Roswell, NM 88203 | 2009-10-16 |
| 1780825372 | Complete Rehab Adult Services | Clinic/Center | 109 W Bland, Roswell, NM 88203 | 2009-03-12 |
| 1710127220 | Roswell Medical Care | Health Maintenance Organization | 111 W Hobbs, Roswell, NM 88203 | 2009-02-23 |
| 1336330513 | Savitri Aguiar | Internal Medicine | 1511 South Grand, Roswell, NM 88203 | 2007-08-05 |
| 1750455523 | Francisco Casio Bicol Jr. | Occupational Therapist | 200 W 1st St Ste 527, Roswell, NM 88203 | 2006-11-20 |
| 1699861542 | Susan Lee Voigt | Counselor | 200 W 1st, Ste 532, Roswell, NM 88203 | 2006-10-05 |
| 1245336940 | Founders Healthcare LLC | Durable Medical Equipment & Medical Supplies | 104 N Missouri Ave, Roswell, NM 88203 | 2006-09-16 |
| Find all providers in zip 88203 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780217513 | Abigail Drew Pothen | Nurse Practitioner | 11660 Alpharetta Hwy Ste 700, Roswell, GA 30076-4956 | 2020-02-20 |
| 1295367464 | Haley Hodoval | Nurse Practitioner | 1250 Upper Hembree Rd Ste B, Roswell, GA 30076-4651 | 2020-02-06 |
| 1306477153 | Jessica Mae Kirby | Nurse Practitioner | 2370 Ashton Dr, Roswell, GA 30076-4232 | 2020-01-30 |
| 1659921625 | Charmaine P Grant | Nurse Practitioner | 540 E Crossville Rd Ste 210, Roswell, GA 30075-7661 | 2019-09-12 |
| 1720190515 | Tina H Strickland | Nurse Practitioner | 1380 Upper Hembree Road, Roswell, GA 30076 | 2006-08-31 |
| 1073523478 | Kimberly A Hansen | Nurse Practitioner | 109 W Bland St, Roswell, NM 88203-5708 | 2006-08-08 |
| 1881602274 | Heather A Carl | Nurse Practitioner | 1295 Hembree Rd Ste 101, Roswell, GA 30076-5721 | 2006-08-03 |
| 1831180405 | Katherine E Mallion | Nurse Practitioner | 1511 S Grand Ave, Roswell, NM 88203-5407 | 2005-11-02 |
| 1457340978 | Ingrid Lea Bloomfield | Nurse Practitioner | 4500 Hospital Blvd Ste 320, Roswell, GA 30076-0001 | 2005-10-18 |
| 1467445262 | North Fulton Anesthesia Associates PC | Nurse Practitioner | 3000 Hospital Blvd, Roswell, GA 30076-4915 | 2005-08-26 |
| Find all providers in ROSWELL | ||||
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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.