M D CORGIAT PA (NPI# 1750550075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750550075 |
| Entity Type | Organization |
| Organization Name | M D CORGIAT PA |
| Other Organization Name | MARK D. CORGIAT, PH.D. |
| Practice Address |
3903 Harrison Blvd Suite 305 Ogden UT 84403-2314 |
| Practice Telephone | 8013873807 |
| Practice Fax Number | 8013873810 |
| Mailing Telephone | 8013873807 |
| Mailing Fax Number | 8013873810 |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2010-09-03 |
| Authorized Official Name | DR. MARK DAVID CORGIAT (OWNER,DIRECTOR) |
| Authorized Official Telephone | 8016216100 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6344743-2501 | UT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1336296003 | 05 | |
| UT | PERSONAL NPI | 1336296003 | 01 |
| Other Name | Type Code |
|---|---|
| Mark D. Corgiat, Ph.D. | Other Name - Individual/Organization |
| Street Address |
3903 HARRISON BLVD SUITE 305 |
| City | OGDEN |
| State | UT |
| Zip Code | 84403-2314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174540090 | Ihc Health Services, Inc. | Clinic/Center | 3903 Harrison Blvd, Ogden, UT 84403-2314 | 2006-07-16 |
| 1861928418 | Camille Koga | Physical Therapy Assistant | 3903 Harrison Blvd, Suite 400, Ogden, UT 84403-2314 | 2017-05-02 |
| 1699225045 | Jennifer Fong | Occupational Therapist | 3903 Harrison Blvd, 400, Ogden, UT 84403-2314 | 2016-10-10 |
| 1003267659 | Michelle Nelson | Speech-Language Pathologist | 3903 Harrison Blvd, Ogden, UT 84403-2314 | 2016-06-24 |
| 1689035321 | Kathryn Carlson | Occupational Therapist | 3903 Harrison Blvd, Suite 400, Ogden, UT 84403-2314 | 2016-03-08 |
| 1558778027 | Shuree Sorensen | Social Worker | 3903 Harrison Blvd, Ogden, UT 84403-2314 | 2014-07-16 |
| 1528496494 | Ryan Spencer | Physical Therapist | 3903 Harrison Blvd, Suite 400, Ogden, UT 84403-2314 | 2013-10-31 |
| 1679900674 | April Meyer Vogt | Speech-Language Pathologist | 3903 Harrison Blvd, Ogden, UT 84403-2314 | 2013-10-04 |
| 1013355619 | Kallie Dawn Martin | Occupational Therapist | 3903 Harrison Blvd, 400, Ogden, UT 84403-2314 | 2013-06-06 |
| 1962751271 | Tama R John | Speech-Language Pathologist | 3903 Harrison Blvd, Ogden, UT 84403-2314 | 2012-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235744632 | Megan Louise Larkins | Specialist/Technologist | 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 | 2020-09-11 |
| 1154959062 | Joshua Clifford Hansen | Student in an Organized Health Care Education/Training Program | 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 | 2020-03-28 |
| 1346895935 | Positional Release Therapy Institute LLC | Specialist/Technologist | 1702 E. 5600 S., Ogden, UT 84403 | 2019-08-09 |
| 1841842077 | Braken Wooden | Chiropractor | 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 | 2019-07-09 |
| 1023670569 | Wasatch Advanced Dental Care LLC | Dentist | 3590 Harrison Blvd Suite #1, Ogden, UT 84403 | 2019-07-05 |
| 1194237636 | Marci Niemeyer | Physician Assistant | 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 | 2017-10-24 |
| 1578081949 | Stephanie Jensen | Specialist/Technologist | 1473 36th Street, Ogden, UT 84403 | 2017-09-06 |
| 1891213385 | Forrest Sutherland | Specialist/Technologist | 1075 E 41st St., Ogden, UT 84403 | 2017-09-05 |
| 1184159022 | Nicole Lee Van Tassell | In Home Supportive Care | 1496 East 5600 South, Unit 6, Ogden, UT 84403 | 2017-04-28 |
| 1265889166 | Modern Dental Professionals Ut, PC | Dentist | 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 | 2016-05-20 |
| Find all providers in zip 84403 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770069981 | Vanessa Blair Watts | Psychologist | 1740 Combe Rd Ste 5, Ogden, UT 84403-5094 | 2018-07-11 |
| 1881986305 | Abigail Lauren Jenkins | Psychologist | 3836 N 700 E, Ogden, UT 84414 | 2011-05-03 |
| 1881751998 | Susan Jones Carcelli | Psychologist | 425 E 5350 S Ste 370, Ogden, UT 84405-7410 | 2007-01-02 |
| 1639236367 | Carcelli & Carcelli PC | Psychologist | 4699 Harrison Blvd Ste 300, Ogden, UT 84403-4368 | 2007-01-02 |
| 1417581950 | Ogden Center for Change, LLC | Psychologist | 3544 Lincoln Ave Ste A, Ogden, UT 84401-4034 | 2020-02-24 |
| 1417506270 | Ogden Psychological Services LLC | Psychologist | 1186 E 4600 S Ste 440, Ogden, UT 84403-4868 | 2019-09-04 |
| 1437400447 | Jonathan Ahern | Psychologist | 5030 Harrison Blvd, Ogden, UT 84403-4311 | 2012-10-01 |
| 1881963700 | David Paul Johnson | Psychologist | 3544 Lincoln Ave Ste A, Ogden, UT 84401-4034 | 2011-12-21 |
| 1740355163 | Norman Stillwell Anderson IIi | Psychologist | 4403 Harrison Blvd, Ogden, UT 84403-3271 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205433059 | Steven Lucero | Psychologist | 93 S 1250 E, Logan, UT 84321-6770 | 2020-10-05 |
| 1023627759 | Wasatch Front Wellness, Pllc | Psychologist | 940 N 400 E Ste 3, North Salt Lake, UT 84054-1945 | 2020-07-29 |
| 1376165530 | Kirsten Leigh Graham | Psychologist | 351 W University Blvdgeneral Classrooms 308-o, General Classrooms 308-o, Cedar City, UT 84720 | 2020-05-11 |
| 1467073833 | Realign Psychology LLC | Psychologist | 1042 E Fort Union Blvd, #1085, Midvale, UT 84047-1800 | 2020-04-27 |
| 1508404344 | Rith Counseling and Assessment Pllc | Psychologist | 10432 S 4000 W, South Jordan, UT 84009-5729 | 2019-12-11 |
| 1780230433 | Carolynne Elizabeth Baron | Psychologist | Va Salt Lake City Healthcare System 500 Foothill Drive, Salt Lake City, UT 84148-0001 | 2019-08-16 |
| 1255999637 | Thomas Golightly | Psychologist | 1500 Wsc Byu, Provo, UT 84602 | 2019-05-31 |
| 1639732571 | Scott A Baldwin | Psychologist | 1190 N 900 E Ofc 285, Provo, UT 84604-3536 | 2019-04-16 |
| 1407311087 | Hiu Wai Caldwell | Psychologist | 796 E. Pacific Drive Suite B, American Fork, UT 84003-8400 | 2019-02-07 |
| 1992273734 | Tracy Ellis | Psychologist | 70 N Main St Ste 104, Bountiful, UT 84010-6115 | 2018-11-09 |
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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.