MR. JASON L BLACK (APRN-C) – Family Nurse Practitioner, NPI 1306013305
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for MR. JASON L BLACK (APRN-C)
1600 US Highway 79 S
Henderson, TX 756544508
Phone: (903) 717-3260
Type: Location
1407, West Baddour Parkway, West End Heights, Lebanon, Wilson County, Tennessee, 37087, United States
LEBANON, TN 370872513
Phone: (615) 444-6203
Fax: (615) 444-6252
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $106.
Total Amount is formed as General ($106) + Research ($0) + Ownership ($0) = $106.
Last reported payment date: 2024-10-09 • Largest payer in this snapshot: Boston Scientific Corporation ($41).
Total Amount
$106
General + Research + Ownership
Payments
6
Total payment records
General Amount
$106
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $41 |
| Bayer Healthcare Pharmaceuticals Inc. | $32 |
| Astellas Pharma US Inc | $17 |
| Amgen Inc. | $16 |
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: 2021-09-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-07-31 (1044 days ago).
Enrollment records
5
Earliest due date
2023-07-31
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 |
|---|---|---|---|---|
| I20110706000460 | I | Nurse Practitioner | TN | 2023-07-31 |
| I20200522002021 | I | Nurse Practitioner | TX | TBD |
| I20210201001273 | I | Nurse Practitioner | IA | TBD |
| I20210217002780 | I | Nurse Practitioner | OR | TBD |
| I20210914001715 | I | Nurse Practitioner | AL | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 75654)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | TN | 85610 | Blood test, clotting time | 44 | 28 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | TN | |
| Family Practice | TN | |
| Family Practice | TN | |
| Internal Medicine, Pediatric Medicine | TN | |
| Nurse Practitioner | TN | |
| Family Practice | TN | |
| Family Practice, Emergency Medicine, General Practice | TN | |
| - | TN | |
| Physician Assistant | TN | |
| - | TN |
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