JENNIFER LEIGH BLACK (APRN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1710347943
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,532 NURSE PRACTITIONER in IA
Provider Addresses for JENNIFER LEIGH BLACK (APRN)
1905 Argyle St
Hamburg, IA 516401503
Phone: (712) 246-7400
Fax: (712) 246-7319
Type: Location
Medical Clinic, 1219, Main Street, Hamburg, Fremont County, Iowa, 51640, United States
HAMBURG, IA 516401300
Phone: (712) 382-2626
Fax: (712) 382-1931
Type: Location
711 S VINE ST
GLENWOOD, IA 515341927
Phone: (712) 525-1397
Type: Location
16000 CHRISTENSEN RD STE 200
TUKWILA, WA 981882925
Phone: (702) 483-5020
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 15 Open Payments records for all available years, with a total value of $312.
Total Amount is formed as General ($312) + Research ($0) + Ownership ($0) = $312.
Last reported payment date: 2024-11-26 • Largest payer in this snapshot: ITI, Inc. ($104).
Total Amount
$312
General + Research + Ownership
Payments
15
Total payment records
General Amount
$312
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. | $104 |
| Teva Pharmaceuticals USA, Inc. | $78 |
| Alkermes, Inc. | $72 |
| Neurocrine BioSciences Inc. | $26 |
| Lundbeck LLC | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-09-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180118002133 | I | Nurse Practitioner | IA | TBD |
| I20200526000024 | I | Nurse Practitioner | TX | TBD |
| I20250911003551 | I | Nurse Practitioner | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 51640)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | WA | |
| Clinical Social Worker | WA | |
| Mental Health Counselor | MO | |
| Nurse Practitioner | ID | |
| Mental Health Counselor | WA | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | WA | |
| Nurse Practitioner | WA | |
| P S Y C H I A T R Y | MS |
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