MARK DALE JOHNSON (NPI# 1184668659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184668659 |
| Entity Type | Individual |
| Full Name | MARK DALE JOHNSON |
| Credential | MD |
| Practice Address |
6321 S Redwood Rd Suite 201 Salt Lake City UT 84123-6798 |
| Practice Telephone | 8012652212 |
| Practice Fax Number | 8012650103 |
| Mailing Telephone | 8012652212 |
| Mailing Fax Number | 8012650103 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2011-06-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 182573-1205 | UT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 529190498001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427528546 | Mark Johnson | Urology | 278 Franklin Rd Ste 150, Brentwood, TN 37027-3265 | 2018-12-01 |
| 1437692787 | Mark Johnson | Pharmacist | 500 N Claude Lord Boulevard, Pottsville, PA 17901-3868 | 2016-11-18 |
| 1902277734 | Mark Johnson Sr. | Counselor | 5310 Eagle Creek Blvd, Shakopee, MN 55379-8617 | 2015-10-20 |
| 1295175966 | Mark Johnson | Pharmacist | 418 Opal Ln, Hibbing, MN 55746-3844 | 2013-06-26 |
| 1275971988 | Mark A Johnson | Dentist | 1714 W Hunt Hwy Ste 100, Queen Creek, AZ 85143-5245 | 2013-06-05 |
| 1598009938 | Mark R Johnson | Pharmacist | 273 12th St Ne, Unit 313, Atlanta, GA 30309-3853 | 2012-11-26 |
| 1164778619 | Mark Anthony Johnson | Pharmacist | 3449 Rezanof Drive, Kodiak, AK 99615 | 2012-08-01 |
| 1881953578 | Mark Joseph Johnson | Anesthesiology | 2810 N Swan Rd Ste 1002810n, Tucson, AZ 85712-6305 | 2012-05-15 |
| 1811261662 | Mark Johnson | Physical Therapist | 3303 Sw Bond Ave Fl 1, Portland, OR 97239-4501 | 2012-02-25 |
| 1639470636 | Mark Johnson | Counselor | 4314 W Lovers Ln, Dallas, TX 75209-2804 | 2010-11-06 |
| Street Address |
6321 S REDWOOD RD SUITE 201 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84123-6798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477541506 | Tanya Chesley | Physician Assistant | 6321 S Redwood Rd, Ste 201, Salt Lake City, UT 84123-6798 | 2005-10-12 |
| 1104361591 | Genesis Vascular of Salt Lake | Radiology | 6321 S Redwood Rd, Suite 102, Salt Lake City, UT 84123-6798 | 2016-12-21 |
| 1770509754 | Jordan Ridge Family Medicine Pllc | Family Medicine | 6321 S Redwood Rd, Ste 201, Salt Lake City, UT 84123-6798 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679186837 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5792 South Redwood Road, Taylorsville, UT 84123 | 2020-08-27 |
| 1164040614 | Mark E Hutchinson | Counselor | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| 1396259321 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4082 South Redwood Road, West Valley Road, UT 84123 | 2017-11-29 |
| 1083131890 | Kelli Mcstotts | Counselor | 5689 S. Redwood Road, Taylorsville, UT 84123 | 2017-08-23 |
| 1740706571 | Laura B Ellsworth | Case Manager/Care Coordinator | 5667 So. Redwood Road, 6b, Salt Lake City, UT 84123 | 2017-08-14 |
| 1790214120 | Integrated Autism Therapies | Behavioral Analyst | 5984 S. Susquehanna, Murray, UT 84123 | 2017-06-08 |
| 1083163885 | Michael John Flint | Counselor | 5861 South Redwood Road, #24, Taylorsville, UT 84123 | 2016-09-22 |
| 1548716236 | Andres Ramos | Licensed Psychiatric Technician | 697 West 4170 South, Murray, UT 84123 | 2016-09-01 |
| 1467807040 | Sheryl R Schindler | Counselor | 5770 South 1550 West, Bldg G, Primary Children's Counseling Center, Taylorsville, UT 84123 | 2016-05-02 |
| 1730562141 | Megan Merica Snarr | Dentist | 597 West 5300 South, Murray, UT 84123 | 2015-07-02 |
| Find all providers in zip 84123 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356957468 | Aubrie Dawn Tilley | Family Medicine | 1741 E Imperial Park Ln, Salt Lake City, UT 84106-3379 | 2020-09-23 |
| 1457969834 | Sandra Lee Porter | Family Medicine | 3979 S Jester Dr, Salt Lake City, UT 84123-1227 | 2020-07-21 |
| 1265057673 | Onsite Care Clinics | Family Medicine | 230 S 500 E Ste 510, Salt Lake City, UT 84102-2028 | 2020-06-11 |
| 1467097071 | Centric Physicians Intermountain Region, Pllc | Family Medicine | 7101 N Mesa Street #365, Salt Lake City, UT 84101-1603 | 2019-11-07 |
| 1760036024 | Mindy Marie Wade | Family Medicine | 1950 E Fort Union Blvd, Salt Lake City, UT 84121-6894 | 2019-07-25 |
| 1841854338 | Tandy Muse | Family Medicine | 4460 S Highland Dr Ste 400, Salt Lake City, UT 84124-3565 | 2019-04-30 |
| 1821561408 | Terra Bowden | Family Medicine | 450 S 900 E Ste 175, Salt Lake City, UT 84102-2981 | 2019-01-07 |
| 1801379193 | Country Corner Family Medicine | Family Medicine | 5460 W Clernates Dr, Salt Lake City, UT 84118-8526 | 2018-09-12 |
| 1396259008 | Futura Medical Clinic | Family Medicine | 1407 W North Temple Ste 120, Salt Lake City, UT 84116-3187 | 2017-11-17 |
| 1255858734 | Fjm Basecamp | Family Medicine | 185 S State St Ste 208, Salt Lake City, UT 84111-1558 | 2017-08-25 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84123 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.