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SPENCER EVAN BLACK MD
NPI 1053842914
Psychiatry & Neurology - Child & Adolescent Psychiatry in Lehi, UT

Active since March 22, 2017PECOS Enrolled
2250 N MILLER CAMPUS DR, LEHI, UT 84043(859) 313-7711(385) 531-1805 Get Directions Write a Review

NPPES record last updated: February 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 3, 2023, May 2, 2022, Oct 15, 2020 and 2 more (5 updates tracked since 2017).

About Spencer Evan Black Md NPPES

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

SPENCER EVAN BLACK MD (NPI 1053842914) is an individual child & adolescent psychiatry provider in Lehi, Utah, licensed in Utah (12759564-8905) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053842914
Entity TypeIndividualMale
Primary Taxonomy2084P0804X
Provider Legal NameSPENCER EVAN BLACKCredential: MD
Location Address2250 N MILLER CAMPUS DRLehi, UT 84043-7233
Mailing Address295 S Chipeta WaySalt Lake City, UT 84108-1287 · (859) 313-7711
Phone(859) 313-7711
Fax(385) 531-1805
Sole ProprietorYes
Enumeration DateMarch 22, 2017
Last NPPES UpdateFebruary 20, 20245 updates tracked since enumeration
NPPES CertifiedFebruary 20, 2024
✔ NPI 1053842914 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in UT · 12759564-8905
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPediatricsTaxonomy 208000000X · License 12759564-1205 (UT)
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 12759564-1205 (UT)
2250 N MILLER CAMPUS DR, Lehi, UT 84043
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah 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 (PECOS)

Spencer Evan 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 20

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

TIMOTHY FOWLES
Psychologist (Clinical)
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (801) 824-6047
DR. JACKIE MARIE NELSON PSY.D.
Psychologist (Clinical)
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (801) 662-1000
ASHLEE NICOLE SADDLER
Occupational Therapist (Mental Health)
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (801) 662-1000
ALEXANDRA WEISZ LMFT
Marriage & Family Therapist
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (801) 662-3603
STACY MICHELLE FENTON MSW
Social Worker (Clinical)
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (801) 662-3601
IHC HEALTH SERVICES, INC.
Pharmacy (Community/Retail Pharmacy)
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (435) 531-1143
MICHELLE WELLER
Speech-Language Pathologist
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (833) 577-3422
BROOKLYN KAYE SIMON OTR/L
Occupational Therapist
2250 N MILLER CAMPUS DR
LEHI, UT 84043
Utah County (833) 577-3422

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 Spencer Black's NPI number?

The NPI number for Spencer Black is 1053842914. It was assigned to this individual provider in the NPPES registry on March 22, 2017.

Where is Spencer Black located?

Spencer Black practices at 2250 N Miller Campus Dr, Lehi, UT 84043. The listed phone number is (859) 313-7711.

What is Spencer Black's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Spencer Black enrolled in Medicare?

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

What insurance does Spencer Black accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Spencer 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.

When was this NPI record last updated?

The NPPES record for Spencer Black was last updated on February 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.