NPI Code Detail JSON Logo

1558626689 NPI number — ADAM HARRIS BLACK NP

NPI Number: 1558626689
Health Care Provider/Practitioner: ADAM HARRIS BLACK NP

Information about “1558626689” NPI (ADAM HARRIS BLACK NP) exists in 1558626689 in HTML format HTML  |  1558626689 in plain Text format TXT  |  1558626689 in PDF (Portable Document Format) PDF  |  1558626689 in an XML format XML  formats.

NPI Number : 1558626689 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558626689",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BLACK",
    "FirstName": "ADAM",
    "MiddleName": "HARRIS",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7171 BUFFALO SPEEDWAY",
    "SecondLineMailingAddress": "APT 535",
    "MailingAddressCityName": "HOUSTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77025-1424",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "205-960-6362",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "213 W MAPLEWOOD LN STE 350",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NASHVILLE",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37207-2992",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "615-961-5878",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/04/2012",
    "LastUpdateDate": "08/13/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163WP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Registered Nurse",
          "LicenseNumber": "N13318",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Registered Nurse",
          "LicenseNumber": "AP61654453",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "AP61654453",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Registered Nurse",
          "LicenseNumber": "APRN11029594",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "0024193322",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "APRN11029594",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "4047534",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Registered Nurse",
          "LicenseNumber": "4047534",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Registered Nurse",
          "LicenseNumber": "0024193322",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Registered Nurse",
          "LicenseNumber": "4704426738",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Registered Nurse",
          "LicenseNumber": "0036390",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "197333",
          "LicenseNumberStateCode": "TN",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "0036390",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LF0000X",
          "TaxonomyName": "Family Nurse Practitioner",
          "LicenseNumber": "4704426738",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.