Mat Ventures LLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

MAT VENTURES LLC

Practice address

8388 S Wasatch Blvd
Cottonwood Heights, UT 84121-6075

Phone

(801) 558-6564

NPI assigned

Mar 26, 2020

Organization subpart

No

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

Authorized official

Name

Corey MarkisichNPI 1033438288

Title

Owner

Phone

(801) 558-6564

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Corey James Markisich, LSAC

  • Addiction (Substance Use Disorder) Counselor
  • Midvale, UT
  • NPI 1033438288
  NPD Authorized official
• Amy Elizatbeth Abshere

  • Addiction (Substance Use Disorder) Counselor
  • Sandy, UT
  • NPI 1831984285

  Single Specialty

  NPD

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1467089607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840200601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8388 S WASATCH BLVD",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841216075",
            "telephone_number": "801-558-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAT VENTURES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "MARKISICH",
        "authorized_official_first_name": "COREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-558-6564"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Elaine Martin, PHARMD
• Denise Martinez Gascoigne, MS, RD, CN
• Guadalupe Martinez-Garcia
• Aspen Martinez
• Emily Alicia Martinez
• Kahopewai Mateaki
• Kyle Shigeru Matsumura, MD
• Mary E Mattingly
• Garan Maughan
• Maybird Medical, PLLC

• All providers in Cottonwood Heights, UT
• Addiction Medicine (Family Medicine) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.