Active NPI
Samuel Marquez, CPSS
- Peer Specialist
- South Salt Lake, UT
National Provider Identifier
1235898297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 1581
- Practice address
- 3269 S Main St Ste 230
South Salt Lake, UT 84115-3769 - Phone
- (801) 935-4447
- NPI assigned
- Dec 16, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 1581 | UT | Primary |
Addresses
Primary practice location
3269 S Main St Ste 230
South Salt Lake, UT 84115-3769
Mailing address
3269 S Main St Ste 230
South Salt Lake, UT 84115-3769
Phone (801) 935-4447
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1581 | UT | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639612800000",
"number": "1235898297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3269 S MAIN ST STE 230",
"city": "SOUTH SALT LAKE",
"state": "UT",
"postal_code": "841153769",
"telephone_number": "801-935-4447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3269 S MAIN ST STE 230",
"city": "SOUTH SALT LAKE",
"state": "UT",
"postal_code": "841153769",
"telephone_number": "801-935-4447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARQUEZ",
"first_name": "SAMUEL",
"credential": "CPSS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-16",
"last_updated": "2021-12-16",
"certification_date": "2021-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "UT",
"license": "1581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Salt Lake, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.