DR EVAN G BLACK LLC (NPI# 1902074115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902074115 |
| Entity Type | Organization |
| Organization Name | DR EVAN G BLACK LLC |
| Other Organization Name | ROCKY MOUNTAIN NEUROLOGY |
| Practice Address |
5323 Woodrow St # 120w Suite 201 Murray UT 84107-5841 |
| Mailing Address |
Po Box 95970 South Jordan UT 84095-0970 |
| Practice Telephone | 8012614711 |
| Practice Fax Number | 8012614769 |
| Mailing Telephone | 8013529500 |
| Mailing Fax Number | 8013529502 |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2009-02-12 |
| Authorized Official Name | JENNIFER DAWSON (CLINIC MANAGER) |
| Authorized Official Telephone | 8014085702 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 187597-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | RAILRAOD MEDICARE | 130012929 | 01 |
| UT | 1902074115 | 05 |
| Other Name | Type Code |
|---|---|
| Rocky Mountain Neurology | Doing Business As Name - Organization |
| Street Address |
5323 WOODROW ST # 120W SUITE 201 |
| City | MURRAY |
| State | UT |
| Zip Code | 84107-5841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083704688 | Paul Andrew House | Neurological Surgery | 5171 S Cottonwood St Ste 950, Murray, UT 84107-5713 | 2006-10-13 |
| 1942260617 | Mark V Reichman | Neurological Surgery | 5171 Cottonwood St, Suite 950, Murray, UT 84107-5704 | 2006-03-25 |
| 1669732830 | University of Utah Neurosurgery Imc | Neurological Surgery | 5171 Cottonwood St, Ste 945, Murray, UT 84107-5704 | 2012-05-22 |
| 1194083915 | Nam Keun Yoon | Neurological Surgery | 5171 S Cottonwood St Ste 950, Murray, UT 84107-5713 | 2012-04-30 |
| 1700066768 | Peter Hanks Maughan | Neurological Surgery | 5171 Cottonwood St, Suite 950, Murray, UT 84107-5704 | 2007-11-07 |
| 1477695187 | Neurosurgical Associates LLC | Neurological Surgery | 5171 Cottonwood St, # 950, Murray, UT 84107-5704 | 2007-02-12 |
| 1679533343 | John R Macfarlane | Neurological Surgery | 5171 Cottonwood St, Suite 950, Murray, UT 84107-5704 | 2006-03-25 |
| 1124088802 | Richard H Tippets | Neurological Surgery | 5171 Cottonwood St, Ste 950, Murray, UT 84107-5704 | 2006-03-25 |
| 1851351530 | Charles C Rich | Neurological Surgery | 5171 Cottonwood St, Ste 950, Murray, UT 84107-5704 | 2006-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073975660 | Robert Kim | Neurological Surgery | 175 N Medical Drive East 5th Floor, Salt Lake City, UT 84132-0001 | 2016-03-23 |
| 1912341009 | Andrea Brock | Neurological Surgery | 3000 N Triumph Blvd Ste 330, Lehi, UT 84043-4999 | 2013-04-19 |
| 1689819146 | James Leo Mcgauley | Neurological Surgery | 8884 Alpen Way, Salt Lake City, UT 84121-6159 | 2008-12-11 |
| 1861645087 | Sarah Tamara Menacho | Neurological Surgery | 175 North Medical Drive East, 5th Floor, University of Utah Department of Neurosurgery, Salt Lake City, UT 84132-0001 | 2008-10-31 |
| 1437331592 | Dr Diana D Banks, LLC | Neurological Surgery | 5323 South 120 West, Suite 201, Salt Lake City, UT 84107 | 2007-11-30 |
| 1316165947 | Utah Neurological Clinic, Inc. | Neurological Surgery | 1055 N. 300 W. Ste 400, Provo, UT 84604 | 2007-04-20 |
| 1730249582 | James C Pingree | Neurological Surgery | 1220 E 3900 S Ste 4e, Salt Lake City, UT 84124-1343 | 2006-12-11 |
| 1235219130 | Richard H. Schmidt | Neurological Surgery | 175 N Medical Dr Fl 5, Salt Lake City, UT 84132-2303 | 2006-10-16 |
| 1487744090 | Joel Douglas Macdonald | Neurological Surgery | 82 S 1100 E Ste 103, Salt Lake City, UT 84102-1889 | 2006-10-13 |
| 1336239920 | Kenneth Stephen Yonemura | Neurological Surgery | 6360 S 3000 E Ste 210, Salt Lake City, UT 84121-6972 | 2006-10-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.