KELLY D. BLACK MD, MSC – NPI #1457499592
Emergency Medicine
Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.
KELLY BLACK is a physician located in FORT WORTH, TX. NPPES has assigned the NPI number 1457499592 to KELLY BLACK on February 01, 2007. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207PP0204X from the Health Care Provider Taxonomy code set, which is classified as Emergency Medicine, specializing in Pediatric Emergency Medicine
The NPI profile was previously updated about 5 years ago on Apr 28, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KELLY BLACK below.
NPI Profile for
KELLY D. BLACK
(more than 19 years ago)
FORT WORTH, TX 76104-2733 Phone: (682) 885-4095 Fax: (682) 885-7499
DALLAS, TX 75373-3784 Phone: (682) 885-1855 Fax: (682) 885-1396
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 207PP0204X - Emergency Medicine / Pediatric Emergency Medicine (Primary) |
SD | 8697 |
| 2080P0204X - Pediatrics / Pediatric Emergency Medicine |
KY | 41081 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.
Health Information Exchange (HEI)
HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.
- Endpoint
- [email protected]
- Endpoint type
- Direct Messaging Address
- Endpoint Description
- Content Type
- Affiliation
- N
- Endpoint Location
-
801 7TH AVE,
FORT WORTH, TX 77025-1669
Additional Information
- Refer to Part B
- Order Durable Medical Equipment
- Refer to Home Health Agency
- Order Power Mobility Devices
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See the complete CMS Data Dissemination Notice here.