Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Jackie Evans Black, RN

Community Health Registered Nurse in Provo, UT · enumerated 2006.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1629144308

Verified

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Registry record

Entity type Individual (Type 1)

Name Jackie Evans Black

Credential RN

Sex Female

Practice address 151 S University Ave # 1900, Provo, UT, 84601

Phone (801) 851-7026

Fax (801) 343-8725

Enumeration date Nov 27, 2006

Last updated in NPPES Jul 9, 2007

Taxonomy & licenses

163WC1500X Community Health Registered Nurse Nursing Service Providers · License 218040-3102 (UT) Primary

RN · Registered Nurse: A nurse who completed an accredited nursing program and passed the NCLEX-RN licensure exam. About the RN credential

Other identifiers

Identifier	Type	State	Issuer
998877660009	Medicaid	UT	-
QM0000039389	Other	UT	ALTIUS PROVIDER#
55102	Other	UT	PEHP PROVIDER #
103003506102	Other	UT	SELECT HEALTH PROVIDER #
PR00489	Medicaid	UT	-
73-00012	Other	UT	UNITED HEALTHCARE ID#

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What specialty is Jackie Black?

Jackie Black is registered in NPPES with the primary taxonomy of Community Health Registered Nurse. The taxonomy code describes the provider's classification and area of specialization for claims and credentialing.

Is this the official NPI registry?

No. NPI Portal is a private site built on public CMS NPPES data. The official registry is npiregistry.cms.hhs.gov, operated by CMS.

Other providers at this practice address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2007-07-09.