MARK B SHAH (NPI# 1760405526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760405526 |
| Entity Type | Individual |
| Full Name | MARK B SHAH |
| Credential | MD |
| Practice Address |
5770 Fashion Blvd Murray UT 84107-6548 |
| Mailing Address |
Po Box 30180 Salt Lake City UT 84130-0180 |
| Practice Telephone | 8012692500 |
| Practice Fax Number | 8012692690 |
| Mailing Telephone | 8012692500 |
| Mailing Fax Number | 8012692690 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
6125332-1205 | UT | Allopathic & Osteopathic Physicians |
| Street Address |
5770 FASHION BLVD |
| City | MURRAY |
| State | UT |
| Zip Code | 84107-6548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255304408 | Lisa Doyle | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-02-08 |
| 1881870152 | John G. Robinson, M.d., P.C. | Specialist | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2008-01-16 |
| 1194929083 | Amy Lyn Hansen | Speech-Language Pathologist | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2007-06-13 |
| 1245452515 | Scott James Jolley | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2007-05-03 |
| 1700919354 | Amy Lynne Leiseth | Physical Therapist | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2007-03-13 |
| 1083715445 | John G Robinson | Specialist | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-09-26 |
| 1285737445 | Edward A Loeser | Anesthesiology | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-09-06 |
| 1316049588 | Gaylon K Peterson | Anesthesiology | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-09-01 |
| 1174635494 | Brenda K Blackham | Anesthesiology | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-08-31 |
| 1669585600 | Pardis A Brown | Speech-Language Pathologist | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-08-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245452515 | Scott James Jolley | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2007-05-03 |
| 1598776239 | Sharlene A Miner | Emergency Medicine | 5121 S Cottonwood St, Murray, UT 84107-5701 | 2006-08-10 |
| 1427069152 | Donald W Childs | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-08-10 |
| 1538173612 | Michael B Noyes | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-07-27 |
| 1508889353 | Anthony K Lombardi | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-07-25 |
| 1730102419 | Karen Suprunowicz | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-07-25 |
| 1821011636 | Bruce R Argyle | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-07-25 |
| 1063435873 | David R Barnes | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-07-25 |
| 1720001589 | David A Valenti | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-07-25 |
| 1962425736 | Thomas J Wood | Emergency Medicine | 5770 Fashion Blvd, Murray, UT 84107-6548 | 2006-07-25 |
| Find all providers in MURRAY | ||||
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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.