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CALEB GERALD BLACK MD
NPI 1114714128
Student in an Organized Health Care Education/Training Program in Beavercreek, OH

Active since April 22, 2025PECOS Enrolled
2145 N FAIRFIELD RD, BEAVERCREEK, OH 45431(937) 558-3900 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Caleb Gerald Black Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CALEB GERALD BLACK MD (NPI 1114714128) is an individual student in an organized health care education/training program in Beavercreek, Ohio and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114714128
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameCALEB GERALD BLACKCredential: MD
Location Address2145 N FAIRFIELD RDBeavercreek, OH 45431-2580
Mailing Address2145 N Fairfield RdBeavercreek, OH 45431-2580 · (937) 558-3900
Phone(937) 558-3900
Sole ProprietorNo
Enumeration DateApril 22, 2025
NPPES CertifiedApril 22, 2025
✔ NPI 1114714128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
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.
2145 N FAIRFIELD RD, Beavercreek, OH 45431
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Caleb Gerald Black Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ELIZABETH SMITH DO
Student in an Organized Health Care Education/Training Program
2145 N FAIRFIELD RD
BEAVERCREEK, OH 45431
Greene County (937) 558-3900
DR. JONATHAN MICHAEL STOFER MD, MPH
Family Medicine
2145 N FAIRFIELD RD
BEAVERCREEK, OH 45431
Greene County (937) 702-4031
UROLOGIC PHYSICIANS & SURGEONS INC.
Urology
2145 N FAIRFIELD RD, SUITE B
BEAVERCREEK, OH 45431
Greene County (937) 429-7352
DR. JERIKA ORTLIEB MD
Family Medicine
2145 N FAIRFIELD RD
BEAVERCREEK, OH 45431
Greene County (937) 702-4031

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Caleb Black's NPI number?

The NPI number for Caleb Black is 1114714128. It was assigned to this individual provider in the NPPES registry on April 22, 2025.

Where is Caleb Black located?

Caleb Black practices at 2145 N Fairfield Rd, Beavercreek, OH 45431. The listed phone number is (937) 558-3900.

What is Caleb Black's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Caleb Black enrolled in Medicare?

Yes. Caleb Black is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Caleb Black was last updated on April 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.