SKYELOR BLACK
NPI 1124723275
Student in an Organized Health Care Education/Training Program in Chattanooga, TN
NPI Status: Active since March 30, 2023
Contact Information
975 E 3RD ST # 112
CHATTANOOGA, TN
ZIP 37403
Phone: (423) 778-7817
- Individual
- Male
- Student in an Organized Health Care Educ...
- PECOS Enrolled
About SKYELOR BLACK
This page provides the complete NPI Profile along with additional information for Skyelor Black, a primary care provider established in Chattanooga, Tennessee with a medical specialization in Student In An Organized Health Care Education/training Program. The healthcare provider is registered in the NPI registry with number 1124723275 assigned on March 2023. The practitioner's primary taxonomy code is 390200000X. The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1124723275
- Provider Name
- SKYELOR BLACK
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 975 E 3RD ST # 112 CHATTANOOGA, TN 37403
- Location Phone
- (423) 778-7817
- Mailing Address
- 975 E 3RD ST # 112 CHATTANOOGA, TN 37403
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-30-2023
- Last Update Date
- 03-30-2023
- Code Navigator
A primary care provider (PCP) like Skyelor Black sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Student in an Organized Health Care Education/Training Program
- Taxonomy Code
- 390200000X
- Type
- Student, Health Care
- Taxonomy Description
- An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Medicare Participation & PECOS Enrollment Status
Skyelor Black is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 2 | 4 | 7 | 2 | 3 | 2 | 7 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 4 | 4 | 14 | 2 | 6 | 2 | 14 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 4 + 4 + 1 + 4 + 2 + 6 + 2 + 1 + 4 + 24 = 55 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 55 = 5 | 5 | ||||||||
The NPI number 1124723275 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 14 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1841870870 | ALYSSA DANIELLE-HALL FERRELL Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-2998 |
| 1023699717 | ADAM CARLTON VOLLBERG MD Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1215632377 | TIMOTHY HOUSTON MULLICAN DO Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-2998 |
| 1215632633 | DR. JAMES ROBERT LANEY MD Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1366147159 | KAITLIN NICOLE DETMAR Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1427753524 | MAIKI SATOSHI EGAWA DO Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1710682596 | MICHAEL EVANS JACOBS DO Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1740985142 | DR. MARY E MANGIERI MD Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1982309969 | KRISTIE LING LIAO DO Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1578315362 | ERIC SASSE MD Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1730932112 | ANDREW GRIFFUS DO Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1861967465 | LEAH E MERRICK FNP-C Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1073308607 | VICTORIA RAE CZARUK DO Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
| 1962296699 | AMANDA HERRING DO Individual | Student in an Organized Health Care Education/Training Program | 975 E 3RD ST # 112 CHATTANOOGA, TN 37403 (423) 778-7817 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124723275, enumerated in the NPI registry as an "individual" on March 30, 2023
The provider is located at 975 E 3rd St # 112 Chattanooga, Tn 37403 and the phone number is (423) 778-7817
The provider's speciality is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on March 30, 2023. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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