Individual provider Active NPI

Michael S. McBain, MD, PHARMD

  • Occupational Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1265576292
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
12994430-1205 Issued in UT
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, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PH00039885WAMDPharmacist
12994430-1205UTMDOccupational Medicine Physician
MD60502221WAMDGeneral 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.

Verify at the official NPI Registry.