Samantha Gwen Black, CRNA in Shelby, NC - Medicare Certified Registered Nurse Anesthetist (crna)

Samantha Gwen Black, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Shelby, North Carolina. She graduated from nursing school in 2015 and has 9 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Chs Anesthesia Services Group Inc and her current practice location is 201 E Grover St, Shelby, North Carolina. You can reach out to her office (for appointments etc.) via phone at (980) 487-3000.

Samantha Gwen Black is licensed to practice in North Carolina (license number 231559) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1609232172.

Contact Information

	Samantha Gwen Black, CRNA
	201 E Grover St, Shelby, NC 28150-3917
	(980) 487-3000
	Not Available

Map and Direction

Provider's Profile

Full Name	Samantha Gwen Black
Gender	Female
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	9 Years
Location	201 E Grover St, Shelby, North Carolina
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Samantha Gwen Black graduated from nursing school in 2015

NPI Data:

NPI Number: 1609232172
Provider Enumeration Date: 01/13/2016
Last Update Date: 06/05/2017

Medicare PECOS Information:

PECOS PAC ID: 7113296146
Enrollment ID: I20170707001354

Medical Identifiers

Medical identifiers for Samantha Gwen Black such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609232172	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	231559 (North Carolina)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Atrium Health Cleveland	Shelby, NC	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Chs Anesthesia Services Group Inc	5799007324	548

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samantha Gwen Black allows following entities to bill medicare on her behalf.

Entity Name	East Carolina Anesthesia Associates Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1205996519 PECOS PAC ID: 5092720813 Enrollment ID: O20060215000791

Entity Name	The Charlotte-mecklenburg Hospital Authority
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669738829 PECOS PAC ID: 2961310685 Enrollment ID: O20100309000605

Entity Name	Chs Anesthesia Services Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346649415 PECOS PAC ID: 5799007324 Enrollment ID: O20141209001856

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samantha Gwen Black is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Samantha Gwen Black, CRNA 4400 Golf Acres Drive, Suite A, Charlotte, NC 28208-5906 Ph: (704) 512-6428	Samantha Gwen Black, CRNA 201 E Grover St, Shelby, NC 28150-3917 Ph: (980) 487-3000

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Shelby, NC

Mrs. Martha Buchanan, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 201 E Grover St, Shelby, NC 28150 Phone: 704-487-3000 Fax: 704-476-7417
Mr. Dale Davis, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 201 E Grover St, Shelby, NC 28150 Phone: 704-487-3000 Fax: 704-476-7417
Mr. Allan Anderson, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 201 E Grover St, Shelby, NC 28150 Phone: 704-476-7445 Fax: 704-476-7417
Mr. Christopher M Herring, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 201 E Grover St, Shelby, NC 28150 Phone: 704-487-3000
Mrs. Jennifer West Mcneace, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 201 E Grover St, Shelby, NC 28150 Phone: 704-476-7411
Ms. Nancy Ann Houghtelin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 201 E Grover St, Shelby, NC 28150 Phone: 704-487-3000 Fax: 704-476-7417
Mr. Gayle Eddy Welch, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 201 E Grover St, Shelby, NC 28150 Phone: 980-487-3871

Samantha Gwen Black, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Shelby, NC