Nurse Practitioner, Family
TIMONTHY BLACK
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1992396022 · enumerated 2021-02-01 · record updated 2024-05-16. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 113 SCENIC OUTLET LN STE 2, MOUNT AIRY, NC, 27030-9978 (336) 352-4900 Fax (336) 352-4901 Google Maps Apple Maps OpenStreetMap
- Mailing address 1132 CARTER MOUNTAIN RD, STUART, VA, 24171-3769 (336) 345-6731 Google Maps Apple Maps OpenStreetMap
Specialties
- Student in an Organized Health Care Education/Training Program 390200000X
- Nurse Practitioner, Family 363LF0000X · Primary · License 5014067 NC
In this directory
Locations and evidence
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Practice location
MOUNT AIRY, NC, 270309978
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.