Corey James Markisich, LSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

7220715-6006 Issued in UT

Practice address

7300 S 300 W
Suite 101
Midvale, UT 84047-1962

Phone

(801) 984-1717

Fax

(801) 984-1720

NPI assigned

May 27, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2587/brand/1/csg/21/fhir/r4

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.

• Mat Ventures LLC

  • Addiction Medicine (Family Medicine) Physician
  • Cottonwood Heights, UT
  • NPI 1467089607
  NPD Authorized official
• Mobile Vivitrol, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Draper, UT
  • NPI 1033742994
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1033438288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2179 N 725 W",
            "city": "WEST BOUNTIFUL",
            "state": "UT",
            "postal_code": "840871104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 S 300 W",
            "address_2": "SUITE 101",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471962",
            "telephone_number": "801-984-1717",
            "fax_number": "801-984-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKISICH",
        "first_name": "COREY",
        "middle_name": "JAMES",
        "credential": "LSAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-27",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "7220715-6006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan Marie Malmberg, LPC
• John Thomas Mancini, DMD
• Alia Jordan Manuel
• Marathon Health, LLC
• Cynthia Anne Marin, RDH
• Heather Gregory Marks
• Daniel Marler, CPO
• Abigail Marquez-Gonzalez, CSWI
• Stephen K Martin, O.D.
• Tina C. Martin, O.D.

• Addiction (Substance Use Disorder) Counselor in Midvale, UT
• Providers in Midvale, UT by specialty
• Addiction (Substance Use Disorder) Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.