Active NPI
Mark David Corgiat, PHD
- Clinical Psychologist
- Ogden, UT
National Provider Identifier
1336296003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6344743-2501
- Practice address
- 1829 Choctaw RDG
Ogden, UT 84403-4636 - Phone
- (801) 317-4502
- NPI assigned
- Jan 4, 2007
- Last updated
- Jun 14, 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6344743-2501 | UT | Primary |
Addresses
Primary practice location
1829 Choctaw RDG
Ogden, UT 84403-4636
Mailing address
PO Box 150941
Ogden, UT 84415-0941
Phone (801) 317-4502
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6344743-2501 | UT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DC Corgiat LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Counselor
- Layton, UT
- NPI 1083093702
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623628800000",
"number": "1336296003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 150941",
"city": "OGDEN",
"state": "UT",
"postal_code": "844150941",
"telephone_number": "801-317-4502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1829 CHOCTAW RDG",
"city": "OGDEN",
"state": "UT",
"postal_code": "844034636",
"telephone_number": "801-317-4502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORGIAT",
"first_name": "MARK",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-04",
"last_updated": "2021-06-14",
"certification_date": "2021-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "UT",
"license": "6344743-2501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.