MRS. DAWN MICHELLE BLACK (APRN FNP-C ACHPN) – Family Nurse Practitioner, NPI 1669985792
Family Nurse Practitioner
Main info
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MRS. DAWN MICHELLE BLACK (APRN FNP-C ACHPN)
5229 Lakeshore Rd
Fort Gratiot, MI 480593122
Phone: (810) 388-6300
Fax: (810) 388-6305
Type: Location
33464 Schoenherr Rd Ste 140
Sterling Heights, MI 483126319
Phone: (586) 276-9500
Fax: (586) 276-9510
Type: Location
1 Ford Pl Ste 4C
Detroit, MI 482023450
Phone: (313) 874-6500
Type: Location
36558, Weber Road, Richmond Township, Macomb County, Michigan, 48062, United States
RICHMOND, MI 480623112
Phone: (810) 300-0323
Type: Mailing
Schoenherr Road, Sterling Heights, Macomb County, Michigan, 48312, United States
STERLING HEIGHTS, MI 483126319
Phone: (586) 276-9500
Fax: (586) 276-9510
Type: Location
2372 KRONNER RD
COLUMBUS, MI 480633404
Phone: (810) 300-0323
Type: Mailing
5229 LAKESHORE RD
FORT GRATIOT, MI 480593122
Phone: (810) 388-6300
Fax: (810) 388-6305
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2018-03-22
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20180322000080 | I | Nurse Practitioner | MI | 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 48059)
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