CONNER JAMES BLACK PHD
NPI 1700652948
Psychologist in Riverside, RI
About Conner James Black Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CONNER JAMES BLACK PHD (NPI 1700652948) is an individual psychologist in Riverside, Rhode Island, licensed in Rhode Island (PS02300) and active in the NPI registry since November 2023. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Conner James Black Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Conner Black reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Providence, RI 02903
- Reassigned Medicare billing, Rhode Island enrollment
- 315 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
RIVERSIDE, RI 02915
RIVERSIDE, RI 02915
RIVERSIDE, RI 02915
RIVERSIDE, RI 02915
RIVERSIDE, RI 02915
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 Conner Black's NPI number?
The NPI number for Conner Black is 1700652948. It was assigned to this individual provider in the NPPES registry on November 29, 2023.
Where is Conner Black located?
Conner Black practices at 1011 Veterans Memorial Pkwy, Riverside, RI 02915. The listed phone number is (401) 432-1000.
What is Conner Black's specialty?
The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.
Is Conner Black enrolled in Medicare?
Yes. Conner Black is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Conner Black's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Conner Black reassigns Medicare benefits to Lifespan Physician Group, Inc. (Providence, RI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Conner Black's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Conner Black was last updated on September 16, 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.