Evan G Black (NPI# 1346260247, PAC ID# 6103724554) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEUROLOGY.
Nation Provider ID (NPI) | 1346260247 |
PAC ID by PECOS | 6103724554 |
Professional Enrollment ID | I20031223000339 |
Full Name | Evan G Black |
Address |
1434 E 4500 Suite 100 Salt Lake City UT 84117-4252 |
Gender | M |
Credential | MD |
Medical School | UNIVERSITY OF UTAH SCHOOL OF MEDICINE |
Graduation Year | 1991 |
Primary Specialty | NEUROLOGY |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
460047 | ST MARK'S HOSPITAL |
460042 | LAKEVIEW HOSPITAL |
460060 | LONE PEAK HOSPITAL |
Address | Phone | Organization |
---|---|---|
1200 E 3900, Salt Lake City, UT 84124-1300 | 8012687134 | ST MARKS PROFESSIONAL SERVICES LLC |
1434 E 4500, Suite 100, Salt Lake City, UT 84117-4252 |
Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
---|---|---|---|
ACI_EC_TRANS_EP_1 | e-Prescribing | 71% | |
ACI_EC_TRANS_PEA_1 | Provide Patient Access | 100% |
Street Address |
1434 E 4500 SUITE 100 |
City | SALT LAKE CITY |
State | UT |
Zip | 84117-4252 |
Name | Specialty | Organization | Address |
---|---|---|---|
Diana D Banks | Neurology | 1434 E 4500, Suite 100, Salt Lake City, UT 84117-4252 | |
Erika C Lloyd | General Surgery | 1434 E 4500, Suite 200, Salt Lake City, UT 84117-4255 |
Name | Specialty | Organization | Address |
---|---|---|---|
David A Mehregan | Pathology | Utah Pathology Service Inc | 5330 S 900 E, Suite 120, Salt Lake City, UT 84117-3504 |
Julie A Jackson | Pathology | Utah Pathology Service Inc | 5330 S 900 E, Suite 120, Salt Lake City, UT 84117-3504 |
Isaac E Lloyd | Pathology | Utah Pathology Service Inc | 5330 S 900 E, Suite 120, Salt Lake City, UT 84117-3504 |
Ralph W Gant | Clinical Psychologist | 5525 S 900 E Plaza II, Suite 102, Murray, UT 84117-3505 | |
Scott Asay | Chiropractic | Apollo Health Centers | 5525 S 900, Suite 310, Murray, UT 84117-3516 |
Timothy P Young | Family Medicine | Apollo Health Centers | 5525 S 900, Suite 310, Murray, UT 84117-3516 |
Travis Castillon | Chiropractic | Apollo Health Centers | 5525 S 900, Suite 310, Murray, UT 84117-3516 |
Jason Dayne Petersen | Plastic and Reconstructive Surgery | J Dayne Petersen Md PC | 5353 S 960, Salt Lake City, UT 84117-3533 |
Summer Rae Kottsick | Nurse Practitioner | Ihc Health Services Inc | 2160 E 4500, Holladay Pedia N, Salt Lake City, UT 84117-4011 |
Andrea Loving | Nurse Practitioner | 2180 E 4500, Suite 105, Holladay, UT 84117-4017 | |
Find all physicians in zip 84117 |
City | SALT LAKE CITY |
Zip Code | 84117 |
Specialty | NEUROLOGY |
City + Specialty | SALT LAKE CITY + NEUROLOGY |
Please comment or provide details below to improve the information on Evan G Black.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.