Dr Charles Henry Black Iv, DO - Medicare Orthopedic Surgery in Laurel, MS

Dr Charles Henry Black Iv, DO is a medicare enrolled "Orthopaedic Surgery" physician in Laurel, Mississippi. He went to New York College Of Osteo Medicine Of New York Institute Of Technology and graduated in 2006 and has 18 years of diverse experience with area of expertise as Orthopedic Surgery. He is a member of the group practice South Central Clinics, Inc and his current practice location is 1002 Jefferson St., Suite 350, Laurel, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 649-5990.

Dr Charles Henry Black Iv is licensed to practice in Mississippi (license number 23113) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1790988087.

Contact Information

Dr Charles Henry Black Iv, DO
1002 Jefferson St., Suite 350,
Laurel, MS 39440-4306
(601) 649-5990
(601) 425-7510



Physician's Profile

Full NameDr Charles Henry Black Iv
GenderMale
SpecialityOrthopedic Surgery
Experience18 Years
Location1002 Jefferson St., Laurel, Mississippi
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Charles Henry Black Iv attended and graduated from New York College Of Osteo Medicine Of New York Institute Of Technology in 2006
  NPI Data:
  • NPI Number: 1790988087
  • Provider Enumeration Date: 06/06/2007
  • Last Update Date: 01/06/2020
  Medicare PECOS Information:
  • PECOS PAC ID: 0042497554
  • Enrollment ID: I20140725001863

Medical Identifiers

Medical identifiers for Dr Charles Henry Black Iv such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1790988087NPI-NPPES
08107236MedicaidMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207X00000XOrthopaedic Surgery 5101016776 (Michigan)Secondary
207X00000XOrthopaedic Surgery 23113 (Mississippi)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Comfortcare Home HealthLaurel, MSHome health agency
South Central Reg Med CtrLaurel, MSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
South Central Clinics, Inc4385876655106

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Charles Henry Black Iv allows following entities to bill medicare on his behalf.
Entity NameMadison Hma Physician Management Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740359249
PECOS PAC ID: 1355444035
Enrollment ID: O20070319000178

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Entity NameSouth Central Clinics, Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1801226287
PECOS PAC ID: 4385876655
Enrollment ID: O20140515000834

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Charles Henry Black Iv is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Charles Henry Black Iv, DO
Po Box 247,
Laurel, MS 39441-0247

Ph: (601) 649-5990
Dr Charles Henry Black Iv, DO
1002 Jefferson St., Suite 350,
Laurel, MS 39440-4306

Ph: (601) 649-5990

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Orthopaedic Surgery Doctors in Laurel, MS

Dr. Steven Douglas Nowicki, M.D.
Orthopedic Surgery
Medicare: Medicare Enrolled
Practice Location: 1002 Jefferson Street, Suite 350, Laurel, MS 39440
Phone: 601-649-5990    Fax: 601-425-7510
Dr. Richard O'keeffe Jr., M.D.
Orthopedic Surgery
Medicare: Medicare Enrolled
Practice Location: 1002 Jefferson Street, Suite 350, Laurel, MS 39440
Phone: 601-649-5990    
Dr. Edward Randolph Turnbull, M.D.
Orthopedic Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 424 S 13th Ave, Laurel, MS 39440
Phone: 601-649-5990    Fax: 601-425-7510
Thomas B Baylis, MD
Orthopedic Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 1002 Jefferson St, Suite 350, Laurel, MS 39440
Phone: 601-649-5990    
Dr. Cleveland Eric Johnson, M.D.
Orthopedic Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 424 S 13th Ave, Laurel, MS 39440
Phone: 601-649-5990    Fax: 601-425-7510
Dr. Thomas Harold Blake Jr., M.D.
Orthopedic Surgery
Medicare: Medicare Enrolled
Practice Location: 424 S 13th Ave, Laurel, MS 39440
Phone: 601-399-6167    Fax: 601-399-6281
Dr. William A Morrison, MD
Orthopedic Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 1002 Jefferson Street, Suite 350, Laurel, MS 39440
Phone: 601-649-5990    Fax: 601-425-7510

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