DR. MARK VERNON ANDERSON (NPI# 1245455096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245455096 |
| Entity Type | Individual |
| Full Name | DR. MARK VERNON ANDERSON |
| Credential | MD |
| Practice Address |
2390 S Redwood Rd Salt Lake City UT 84119-2027 |
| Mailing Address |
4018 Prospector Dr Salt Lake City UT 84121-4609 |
| Practice Telephone | 8019751600 |
| Practice Fax Number | 8019751666 |
| Mailing Telephone | 8019751600 |
| Mailing Fax Number | 8019751666 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
1660581205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326607383 | Mark Anderson | Massage Therapist | 1978 Addison Ave E, Twin Falls, ID 83301-5304 | 2019-06-12 |
| 1427403468 | Mark Anthony Anderson | Student in an Organized Health Care Education/Training Program | 157 E Rose St, Lebanon, OR 97355-4231 | 2016-04-27 |
| 1356732887 | Mark David Anderson | Licensed Practical Nurse | 227 Island Cottage Rd., Rochester, NY 14612-3627 | 2015-02-05 |
| 1134562903 | Mark William Anderson | Marriage & Family Therapist | 500 S. 580 W., Escalante, UT 84726 | 2013-04-11 |
| 1629334073 | Mark Gruen Anderson | Pharmacist | 2615 Eastern Ave, Plymouth, WI 53073-4270 | 2012-04-10 |
| 1629342928 | Mark Anderson | Social Worker | 140 Griggs Dr, Princeton, NJ 08540-7672 | 2012-03-05 |
| 1912271818 | Mark D Anderson | Licensed Practical Nurse | 4210 Wood Park Dr, Stow, OH 44224-2651 | 2012-02-24 |
| 1982905261 | Mark Alan Anderson | Pharmacist | 860 N Cleveland Ave, Loveland, CO 80537-4717 | 2010-11-03 |
| 1487822771 | Mark R Anderson | Counselor | 106 N Kenosha Dr, Madison, WI 53705-2633 | 2008-02-20 |
| 1174736953 | Mark Arthur Anderson | Specialist | 333 O'connor Dr, San Jose, CA 95128 | 2007-05-08 |
| Street Address |
2390 S REDWOOD RD |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84119-2027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811028160 | Deborah Lynn Mattingly | Preventive Medicine | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2007-03-08 |
| 1700314069 | Nicholas Parlapiano | Physical Therapist | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2017-05-31 |
| 1578814505 | Melanie Che Kammerman | Physician Assistant | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2012-10-01 |
| 1841546504 | Brief Physical Therapy, LLC | Clinic/Center | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2012-07-31 |
| 1134475890 | Work Care Salt Lake, LLC | Clinic/Center | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2012-07-31 |
| 1710270806 | William France Curry IIi | Preventive Medicine | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2011-05-23 |
| 1437467594 | Erick Farr Hennessy | Physician Assistant | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2010-09-22 |
| 1346467719 | Letitia P. Archuleta | Preventive Medicine | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2007-04-19 |
| 1790902179 | Nadia Miniclier Cobb | Physician Assistant | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2007-04-19 |
| 1659404424 | Carla Hoffman Olsen | Preventive Medicine | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2007-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164981932 | Arches Home Care, Inc. | Non-emergency Medical Transport (VAN) | 1385 W 2200 S Ste 203, West Valley City, UT 84119 | 2019-03-19 |
| 1629591003 | Exemplar Healthcare, Inc. | Hospice Care, Community Based | 1385 W 2200 S Ste 202, West Valley City, UT 84119 | 2017-07-18 |
| 1619358496 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 2875 S Decker Lake Dr Ste 180, West Valley City, UT 84119 | 2015-06-17 |
| 1821407735 | Nathan William Stobbe | Dentist | 3280 W. 3500 S. Ste 3, West Valley, UT 84119 | 2014-08-05 |
| 1801209028 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3148 W 3500 S, West Valley City, UT 84119 | 2014-06-05 |
| 1215347935 | Karl Edward Jennings | Social Worker | 3901 S David Pl, West Valley City, UT 84119 | 2014-05-02 |
| 1750624672 | Shannon Quinn Dunlop | Registered Nurse | 2621 S 3270 W, West Valley City, UT 84119 | 2013-03-28 |
| 1215273529 | Holly H Tanski | Counselor | 5770 S. 1500 W. Bld A, Ihc Wasatch Canyons Campus, Salt Lake City, UT 84119 | 2012-12-14 |
| 1982955860 | Oquirrh Meadows Care and Rehab, Inc | Assisted Living Facility | 2948 So. Redwood Road, West Valley City, UT 84119 | 2012-10-02 |
| 1518235068 | Asjad Kaleem Mohammed | Pharmacist | 2290 S Redwood Road, Olive Pharmacy, Salt Lake City, UT 84119 | 2011-12-12 |
| Find all providers in zip 84119 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164707105 | Alice Dowling | Preventive Medicine | 3837 E Sunnydale Ln, Salt Lake City, UT 84108-1523 | 2011-10-20 |
| 1366764540 | Lynne Marie Morgan | Preventive Medicine | 460 Redondo Ave, Salt Lake City, UT 84115-2226 | 2010-02-16 |
| 1538760228 | Summer Soleil Hammond | Preventive Medicine | 515 S 700 E Ste 2a, Salt Lake City, UT 84102-2855 | 2020-11-08 |
| 1659404424 | Carla Hoffman Olsen | Preventive Medicine | 2390 S Redwood Rd, Salt Lake City, UT 84119-2027 | 2007-03-13 |
| 1073640538 | Ihc Health Services Inc | Preventive Medicine | 1685 W 2200 S, Salt Lake City, UT 84119-1456 | 2007-02-28 |
| 1437166659 | Ed Holmes | Preventive Medicine | 500 Foothill Blvd, Building 2, Second Floor C&p Clinic, Salt Lake City, UT 84148-0001 | 2006-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598190472 | Healthstat On-site Clinic/milliken St. Georg | Preventive Medicine | 961 E Commerce Dr, St George, UT 84790-4737 | 2013-09-10 |
| 1346253945 | Susanne Christine Thobe | Preventive Medicine | Bldg 5116 Kister Avenue, Dugway, UT 84022 | 2006-08-14 |
| 1285698217 | Annette G Burst | Preventive Medicine | 3500 Harrison Blvd Ste 200, Ogden, UT 84403-2038 | 2006-04-14 |
| 1568439156 | William C Otto | Preventive Medicine | 629 Coyote Cv, A, Dugway, UT 84022-1079 | 2006-03-02 |
| 1437692324 | Ihc Health Services Inc | Preventive Medicine | 1665 Bonanza Dr, Park City, UT 84060-5127 | 2016-11-23 |
| 1376744086 | Ihc Health Services Inc | Preventive Medicine | 962 Sage Dr, Cedar City, UT 84720-1885 | 2007-05-30 |
| 1982816351 | Philip Jiricko | Preventive Medicine | 2400 N Washington Blvd, North Ogden, UT 84414-7233 | 2007-05-05 |
| 1396968731 | Ihc Health Services Inc | Preventive Medicine | 385 N 3050 E, St George, UT 84790-9003 | 2007-04-11 |
| 1760516629 | Ihc Health Services Inc | Preventive Medicine | 505 W 400 N, Orem, UT 84057-1950 | 2007-03-15 |
| 1245360031 | Ihc Health Services Inc | Preventive Medicine | 1355 Hinkley Dr, Ogden, UT 84401-3376 | 2007-03-07 |
| Find all providers with the same taxonomy | ||||
| City | SALT LAKE CITY |
| Zip Code | 84119 |
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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.