Mark Vernon Anderson, MD

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

1660581205 Issued in UT

Practice address

2390 S Redwood Rd
Salt Lake City, UT 84119-2027

Phone

(801) 975-1600

Fax

(801) 975-1666

NPI assigned

Apr 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245455096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4018 PROSPECTOR DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841214609",
            "telephone_number": "801-975-1600",
            "fax_number": "801-975-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 S REDWOOD RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841192027",
            "telephone_number": "801-975-1600",
            "fax_number": "801-975-1666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARK",
        "middle_name": "VERNON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "UT",
            "license": "1660581205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loni Anderson, NP
• Lydia Wilma Ann Anderson
• Madison Anderson, RDN
• Margaret Brooke Anderson, LCSW
• Mark D Anderson, PT
• Mary Anne Anderson, CMHC
• Mason Taylor Anderson
• Matthew Thomas Anderson, FNP-C
• Melinda Ann Anderson
• Melissa Ann Anderson, CM, CPSS

• Preventive Medicine/Occupational Environmental Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.