Individual provider Active NPI

Mark Housley, MD

  • Family Medicine Physician
  • Ogden, UT
National Provider Identifier
1457358335
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5358316-105 Issued in UT
Practice address
2240 Adams Ave
Ogden, UT 84401-1511
Phone
(801) 393-5355
Fax
(801) 394-4609
NPI assigned
Jul 7, 2005
Last updated
Oct 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5358316-105 UT Primary

Addresses

Primary practice location

2240 Adams Ave
Ogden, UT 84401-1511

Mailing address

2240 Adams Ave
Ogden, UT 84401-1511
Phone (801) 393-5355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031222000430 UT Practitioner - Family Practice 6406754993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2240 Adams Ave
Ogden, UT 84401-1511
Phone (801) 393-5355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5358316-105UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midtown Community Health Center Inc CurrentSince Jan 7, 2015 Accepting new patients
Midtown Community Health Center Inc CurrentSince Jan 7, 2015 Accepting new patients
Midtown Community Health Center Inc Past Accepting new patients

Locations

22 S State St
Clearfield, UT 84015
Phone (801) 525-5000

2240 Adams Ave
Ogden, UT 84401
Phone (801) 393-5355

781 25th St
Ogden, UT 84401
Phone (801) 622-1451

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1457358335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 ADAMS AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011511",
            "telephone_number": "801-393-5355",
            "fax_number": "801-394-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 ADAMS AVE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844011511",
            "telephone_number": "801-393-5355",
            "fax_number": "801-394-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSLEY",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "5358316-105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.