Ivy Black, C-NP
NPI 1104571462 · Family Nurse Practitioner · Kennesaw, GA
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Ivy Black, C-NP is a Family Nurse Practitioner provider in Kennesaw, GA (NPI 1104571462).
Provider details
- NPI number
- 1104571462
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- C-NP
- Sex
- Female
- Sole proprietor
- No
- License
- RN195496 (GA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-02-15
- Last updated
- 2025-06-12
- Certified
- 2025-06-12
Frequently asked questions
- What is Ivy Black's NPI number?
- Ivy Black's National Provider Identifier (NPI) is 1104571462, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Ivy Black's specialty?
- Ivy Black is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Ivy Black located?
- Ivy Black's practice location on file with NPPES is 2782 Cobb Pkwy Nw, Kennesaw, GA 30152-3472.
- What is Ivy Black's phone number?
- The practice phone number listed in the NPPES registry for Ivy Black is (706) 405-1195.
- Does Ivy Black accept Medicare?
- Ivy Black is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Ivy Black's NPI active?
- Yes — Ivy Black's NPI (1104571462) is active in the NPPES registry as of the last update on 2025-06-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.