DR. KRISTIN SHANNON BLACK MD NPI 1609872720

NPI Information

NPI: 1609872720
Provider Name: DR. KRISTIN SHANNON BLACK, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
820 W MEETING ST
LANCASTER, SC
ZIP 29720
Phone: (803) 285-5441
Get Directions

DR. Kristin Shannon Black, MD is a family medicine in Lancaster, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Kristin Shannon Black, MD NPI is 1609872720. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

820 W MEETING ST
LANCASTER, SC
ZIP 29720-202
Phone: (803) 285-5441

The NPI 1609872720 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/23/2005 and was last updated on 9/26/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		9901115	NORTH CAROLINA	No
2	207Q00000X	Family Medicine		22582	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	H48029	MEDICARE UPIN
2	2012607	MEDICARE ID-TYPE UNSPECIFIED	NORTH CAROLINA
3	891330G	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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