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SHANEKKIA BLACK MD
NPI 1164928545
Internal Medicine in Austell, GA

Active since April 04, 2018PECOS EnrolledAccepts Medicare Assignment
92.93/100
CMS Quality Rating
1605 MULKEY RD STE 220, AUSTELL, GA 30106(470) 956-3760(678) 398-1930 Get Directions Write a Review

NPPES record last updated: April 19, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 9, 2021, Jul 20, 2021 (2 updates tracked since 2021).

About Shanekkia Black Md NPPES

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

SHANEKKIA BLACK MD (NPI 1164928545) is an individual internal medicine provider in Austell, Georgia, licensed in Georgia (89381) and active in the NPI registry since April 2018. She is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and maintains a secondary practice location in Austell.

NPPES Registry Identity

NPI1164928545
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameSHANEKKIA BLACKCredential: MD
Location Address1605 MULKEY RD STE 220Austell, GA 30106-1127
Mailing Address1605 Mulkey Rd Ste 220Austell, GA 30106-1127 · (470) 956-3760 · Fax (678) 398-1930
Phone(470) 956-3760
Fax(678) 398-1930
Sole ProprietorNo
Medical School CMSMorehouse School Of MedicineGraduated 2018
Enumeration DateApril 4, 2018
Last NPPES UpdateApril 19, 20232 updates tracked since enumeration
NPPES CertifiedApril 19, 2023
✔ NPI 1164928545 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 89381
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1605 MULKEY RD STE 220, Austell, GA 30106
Open in Google Maps ↗

Secondary Practice Location 1

Location 13825 Medical Park Dr Ste 201Austell, GA 30106-6831 · Phone (779) 941-8100

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shanekkia Black Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628328291
PECOS Enrollment IDI20210726002593
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.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
117 services69 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
41 services41 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
27 services23 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
21 services19 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
13 services12 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wellstar Kennestone Regional Medical Center

Acute Care Hospitals · Marietta, GA
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110035
Location677 Church StreetMarietta, GA 30060 · Cobb County
Emergency services Birthing friendly

Wellstar Paulding Medical Center

Acute Care Hospitals · Hiram, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110042
Location2518 Jimmy Lee Smith ParkwayHiram, GA 30141 · Paulding County

Wellstar Cobb Medical Center

Acute Care Hospitals · Austell, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110143
Location3950 Austell RdAustell, GA 30106 · Cobb County
Birthing friendly

Wellstar Douglas Medical Center

Acute Care Hospitals · Douglasville, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110184
Location8954 Hospital DriveDouglasville, GA 30134 · Douglas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30106 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.64 typical visit price
range $56.84 – $172.43
Typical copayment $32.66 (range $14.21 – $43.10)
Most-billed visit code 99204
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.38
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES

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

SAADIA ILYAS M.D.
Family Medicine
1605 MULKEY RD STE 220
AUSTELL, GA 30106
Cobb County (470) 956-3760

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 Shanekkia Black's NPI number?

The NPI number for Shanekkia Black is 1164928545. It was assigned to this individual provider in the NPPES registry on April 4, 2018.

Where is Shanekkia Black located?

Shanekkia Black practices at 1605 Mulkey Rd Ste 220, Austell, GA 30106. The listed phone number is (470) 956-3760.

What is Shanekkia Black's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Shanekkia Black enrolled in Medicare?

Yes. Shanekkia Black is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shanekkia Black accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Shanekkia Black as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Shanekkia Black affiliated with any hospitals?

According to CMS data, Shanekkia Black is affiliated with Wellstar Kennestone Regional Medical Center, Wellstar Paulding Medical Center, Wellstar Cobb Medical Center and Wellstar Douglas Medical Center.

When was this NPI record last updated?

The NPPES record for Shanekkia Black was last updated on April 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.