Individual provider Active NPI

Mark M Loveless, PA-C

  • Physician Assistant
  • Provo, UT
National Provider Identifier
1063427904
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
53699191206 Issued in UT
Practice address
1134 N 500 W
#100
Provo, UT 84604-3383
Phone
(801) 357-7081
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 53699191206 UT Primary

Addresses

Primary practice location

1134 N 500 W
#100
Provo, UT 84604-3383

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 357-7081

Other names 1

  • Mark Loveless Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031218000786 UT Practitioner - Physician Assistant 9133026834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

1034 N 500
Provo, UT 84604-3380
Phone (801) 357-8879

2075 N 1200
Layton, UT 84041-1611
Phone (801) 779-6200

2075 University Park Blvd
Layton, UT 84041-1611
Phone (801) 387-6200

5323 S Woodrow St
Murray, UT 84107-5841
Phone (801) 261-8346

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
53699191206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Mar 30, 2004 Accepting new patients
Ihc Health Services, Inc. CurrentSince Mar 30, 2004 Accepting new patients
Ihc Health Services Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

1400 N 500 E
North Logan, UT 84341
Phone (435) 716-1000

395 W Cougar Blvd
Ste 503
Provo, UT 84604
Phone (801) 357-4600

1055 N 300 W
Ste 110
Provo, UT 84604
Phone (801) 357-7377

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

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1063427904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-357-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 N 500 W",
            "address_2": "#100",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043383",
            "telephone_number": "801-357-7081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELESS",
        "first_name": "MARK",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "53699191206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "LOVELESS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.