Marc Taylor Mitton, D.O

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OT018578 Issued in PA

Practice address

5748 Adams Ave Pkwy
Washington Terrace, UT 84405-6947

Phone

(801) 827-9100

NPI assigned

Apr 1, 2017

Last updated

Aug 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Dermatology

Education

Rocky Vista University College of Osteopathic Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy DermatologyGroup PAC ID 5991022642, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Legacy Dermatology

  • Medical Specialty Clinic/Center
  • Bountiful, UT
  • NPI 1376944942
  Medicare reassignment Care Compare group NPD
• Rocky Mountain Dermatology Inc

  • Dermatology Physician
  • North Logan, UT
  • NPI 1154527372
  Medicare reassignment NPD

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

{
    "created_epoch": "1491004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1568994143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3794 E 3600 N",
            "city": "LIBERTY",
            "state": "UT",
            "postal_code": "843109506",
            "telephone_number": "801-458-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5748 ADAMS AVE PKWY",
            "city": "WASHINGTON TERRACE",
            "state": "UT",
            "postal_code": "844056947",
            "telephone_number": "801-827-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTON",
        "first_name": "MARC",
        "middle_name": "TAYLOR",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-01",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "OT018578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Littrell, FNP-C
• Marianne Ririe Loertscher, MS/CCC-SLP
• Lonestar Medical PLLC
• Carolie Meccico, L.C.S.W.
• Midtown Community Health Center Inc (Midtown CHC Children's)
• Erika Munns, NP
• Gabriela Yvonne Nava, PHARMD
• Angelina Marie Nelson, APRN
• Occupational Stress Management, LLC
• Ogden Family Chiropractic LLC

• Dermatology Physician in Washington Terrace, UT
• Providers in Washington Terrace, UT by specialty
• Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.