Active NPI
Scott Bayles Black, MD
- Family Medicine Physician
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 8699736-1205
- Practice address
- 475 W 940 N
Provo, UT 84604-3301 - Phone
- (801) 357-7930
- Fax
- (801) 357-7014
- NPI assigned
- May 16, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 8699736-1205 | UT | Primary |
| Family Medicine Physician | 207Q00000X | MD171322 | OR |
Addresses
Primary practice location
475 W 940 N
Provo, UT 84604-3301
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 357-7930
Other practice location 1
51600 Huntington Rd
LA Pine, OR 97739-8887
Phone (541) 536-3435
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service | Other | Bluemark LLC / Office Ally |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
98 N 1100
Suite 103
American Fork, UT 84003-2940
Phone (801) 492-2380
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD171322 | OR | MD | Family Medicine Physician |
| 8699736-1205 | UT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Family Medicine | Current | Accepting new patients |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Past | Accepting new patients |
Locations
98 N 1100 E
Ste 103
American Fork, UT 84003
Phone (801) 492-2330
354 W State Road 73
Saratoga Springs, UT 84045
Phone (801) 341-5200
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
- Emergency Medicine Physician
- Logan, UT
- NPI 1245374313
-
- Multi-Specialty Clinic/Center
- St George, UT
- NPI 1871618850
-
- Multi-Specialty Clinic/Center
- Orem, UT
- NPI 1588601124
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Provo, UT
- NPI 1114025491
-
- General Acute Care Hospital
- American Fork, UT
- NPI 1912014358
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780876800000",
"number": "1811257462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "801-357-7930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 W 940 N",
"city": "PROVO",
"state": "UT",
"postal_code": "846043301",
"telephone_number": "801-357-7930",
"fax_number": "801-357-7014"
}
],
"practiceLocations": [
{
"address_1": "51600 Huntington Rd",
"address_purpose": "LOCATION",
"city": "LA Pine",
"state": "OR",
"postal_code": "977398887",
"country_code": "US",
"telephone_number": "541-536-3435",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BLACK",
"first_name": "SCOTT",
"middle_name": "BAYLES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-16",
"last_updated": "2026-06-08",
"certification_date": "2026-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "8699736-1205",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD171322",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC / Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.