Deronda Ann Black, OTR - Occupational Therapist in Vicksburg, MI

Deronda Ann Black, OTR is a Occupational Therapist - Pediatrics based in Vicksburg, Michigan. Deronda Ann Black is licensed to practice in Indiana (license number 31004281A) and her current practice location is 14416 Portage Rd, Vicksburg, Michigan. She can be reached at her office (for appointments etc.) via phone at (269) 649-1848.

NPI number for Deronda Ann Black is 1316114150 and her current mailing address is Po Box 202, Vicksburg, Michigan. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1316114150.

Contact Information

Deronda Ann Black, OTR
14416 Portage Rd,
Vicksburg, MI 49097-9732
(269) 649-1848
(269) 649-1848

Map and Direction




Healthcare Provider's Profile

Full NameDeronda Ann Black
GenderFemale
SpecialityOccupational Therapist - Pediatrics
Location14416 Portage Rd, Vicksburg, Michigan
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1316114150
  • Provider Enumeration Date: 05/12/2008
  • Last Update Date: 05/12/2008

Medical Identifiers

Medical identifiers for Deronda Ann Black such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1316114150NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225XP0200XOccupational Therapist - Pediatrics 31004281A (Indiana)Primary

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. Deronda Ann Black is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Deronda Ann Black, OTR
Po Box 202,
Vicksburg, MI 49097-0202

Ph: (269) 649-1848
Deronda Ann Black, OTR
14416 Portage Rd,
Vicksburg, MI 49097-9732

Ph: (269) 649-1848

Reviews and Comments


Occupational Therapist in Vicksburg, MI

Ms. Joan Uhley, OTR
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 15423 S Barton Lake Dr, Vicksburg, MI 49097
Phone: 269-584-0085    Fax: 269-649-4647
Kristin K Springer, OTR/L
Occupational Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 7649 S Indian Lake Dr, Vicksburg, MI 49097
Phone: 269-760-4662    

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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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