Individual provider Active NPI

Mark Ogilvie

  • Diagnostic Radiology Physician
  • Murray, UT
National Provider Identifier
1043579873
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
12848372-1205 Issued in UT
Practice address
5217 S State St Ste 200
Murray, UT 84107-4812
Phone
(801) 313-4128
NPI assigned
May 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 42365 AL
Diagnostic Radiology Physician 2085R0202X 12848372-1205 UT Primary

Addresses

Primary practice location

5217 S State St Ste 200
Murray, UT 84107-4812

Mailing address

5217 S State St Ste 200
Murray, UT 84107-4812
Phone (801) 313-4128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, UT, ID, WA4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20180412001358 NV Practitioner - Diagnostic Radiology 3971866559 Reassigns benefits to 4 organizations
I20220609001468 UT Practitioner - Diagnostic Radiology 3971866559 Reassigns benefits to 3 organizations
I20240104000807 ID Practitioner - Diagnostic Radiology 3971866559 Reassigns benefits to 1 organization
I20260227002076 WA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 3971866559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

3903 Medical Dr
Suite 100
Ogden, UT 84403-2316
Phone (801) 387-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12848372-1205UTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Bandt Birkin Kollins & Wong PLLC Diagnostic Radiology CurrentSince Apr 15, 2018 Accepting new patients
Tellica Imaging, LLC CurrentSince Jul 1, 2022 Accepting new patients
Southwest Medical Associates, Inc CurrentSince May 21, 2018 Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology CurrentSince Jan 14, 2026 Accepting new patients
Ihc Health Services Inc CurrentSince Jan 18, 2025 Accepting new patients
Tellica Imaging, LLC CurrentSince Jul 1, 2022 Accepting new patients
Ihc Health Services Inc CurrentSince Jun 1, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology CurrentSince Apr 15, 2018 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 12, 2024 Accepting new patients
Optum Medical Group Rhodes P C Current Accepting new patients
Tellica Imaging, LLC CurrentSince Nov 7, 2023 Accepting new patients
Ihc Health Services, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Tellica Imaging, LLC Diagnostic Radiology CurrentSince Nov 7, 2023 Accepting new patients
Optum Medical Group II Rhodes P C CurrentSince Aug 14, 2019 Accepting new patients
Tellica Imaging, LLC CurrentSince Apr 13, 2023 Accepting new patients
Tellica Imaging - Washington LLC Diagnostic Radiology PastSince Oct 5, 2025 Accepting new patients

Locations

8505 W Overland Rd
Boise, ID 83709
Phone (208) 417-5100

2811 W Horizon Ridge Pkwy
Henderson, NV 89052

1887 Whitney Mesa Dr
Henderson, NV 89014
Phone (702) 819-0368

3920 S Eastern Ave
Ste 100
Las Vegas, NV 89119
Phone (702) 759-8779

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

2020 Palomino Ln
Ste 100
Las Vegas, NV 89106
Phone (702) 759-8779

888 S Rancho Dr
Las Vegas, NV 89106
Phone (702) 877-5375

420 N Nellis Blvd
Las Vegas, NV 89110
Phone (702) 339-5710

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

3903 Medical Dr
Ste 100
Ogden, UT 84403
Phone (801) 387-8900

5217 S State St
Ste 200
Salt Lake City, UT 84107
Phone (208) 417-5100

5217 S State St
Salt Lake City, UT 84107
Phone (801) 313-4110

5295 S Commerce Dr
Ste 550
Salt Lake City, UT 84107
Phone (801) 313-4110

36 S Street St
Ste 2200
Salt Lake Cty, UT 84111
Phone (385) 622-0669

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

421 E Main St
Auburn, WA 98002
Phone (253) 204-2530

2941 S 38th St
Ste E
Tacoma, WA 98409
Phone (253) 534-8689

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1043579873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5217 S STATE ST STE 200",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074812",
            "telephone_number": "801-313-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5217 S STATE ST STE 200",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074812",
            "telephone_number": "801-313-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGILVIE",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AL",
            "license": "42365",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "12848372-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.