Individual provider Active NPI

Mark Allen Rholl, MD

  • Family Medicine Physician
  • Salt Lake City, UT
National Provider Identifier
1366498818
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7512 Issued in AK
Practice address
275 E 200 S
Vista Staffing Solutions
Salt Lake City, UT 84111-2002
Phone
(800) 366-1884
Fax
(866) 360-6021
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10371 NH
Family Medicine Physician 207Q00000X 7512 AK Primary

Addresses

Primary practice location

275 E 200 S
Vista Staffing Solutions
Salt Lake City, UT 84111-2002

Mailing address

275 E 200 S
Vista Staffing Solutions
Salt Lake City, UT 84111-2002
Phone (800) 366-1884

Other identifiers 1

IdentifierTypeStateIssuer
30011548MedicaidNH

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

State licenses

LicenseStateTypeSpecialty
7512AKMDFamily Medicine Physician
10371NHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
York Family Practice Family Medicine PastSince Sep 8, 1998 Accepting new patients
York Hospital Family Medicine PastSince Dec 24, 2012 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Public Hospital District No 1 of Mason County Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1366498818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 E 200 S",
            "address_2": "VISTA STAFFING SOLUTIONS",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841112002",
            "telephone_number": "800-366-1884",
            "fax_number": "866-360-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 E 200 S",
            "address_2": "VISTA STAFFING SOLUTIONS",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841112002",
            "telephone_number": "800-366-1884",
            "fax_number": "866-360-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHOLL",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "10371",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "7512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30011548",
            "state": "NH"
        }
    ],
    "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 Feb 27, 2013; 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.