Active NPI
Michael S. McBain, MD, PHARMD
- Occupational Medicine Physician
- Salt Lake City, UT
National Provider Identifier
1265576292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 12994430-1205
- Practice address
- 250 E 200 S RM 1202
Salt Lake City, UT 84111-2472 - Phone
- (801) 581-3841
- NPI assigned
- Feb 15, 2007
- Last updated
- Aug 23, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | NU | ||
| Pharmacist | 183500000X | PH00039885 | WA | |
| Occupational Medicine Physician | 2083X0100X | 12994430-1205 | UT | Primary |
| General Practice Physician | 208D00000X | MD60502221 | WA |
Addresses
Primary practice location
250 E 200 S RM 1202
Salt Lake City, UT 84111-2472
Mailing address
250 E 200 S RM 1202
Salt Lake City, UT 84111-2472
Phone (801) 581-3841
Other practice location 1
4310 Colby Ave Ste 201
Everett, WA 98203-2338
Phone (425) 952-9687
Other practice location 2
701 Park Ave
G2
Minneapolis, MN 55415-1623
Phone (612) 873-3922
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)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00039885 | WA | MD | Pharmacist |
| 12994430-1205 | UT | MD | Occupational Medicine Physician |
| MD60502221 | WA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661212800000",
"number": "1265576292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E 200 S RM 1202",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841112472",
"telephone_number": "801-581-3841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 E 200 S RM 1202",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841112472",
"telephone_number": "801-581-3841"
}
],
"practiceLocations": [
{
"address_1": "4310 Colby Ave Ste 201",
"address_purpose": "LOCATION",
"city": "Everett",
"state": "WA",
"postal_code": "982032338",
"country_code": "US",
"telephone_number": "425-952-9687",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "701 Park Ave",
"address_2": "G2",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554151623",
"country_code": "US",
"telephone_number": "612-873-3922",
"fax_number": "612-904-4401",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCBAIN",
"first_name": "MICHAEL",
"middle_name": "S.",
"credential": "MD, PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2022-08-23",
"certification_date": "2022-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00039885",
"primary": false
},
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "UT",
"license": "12994430-1205",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "WA",
"license": "MD60502221",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.