Individual provider Active NPI

Mark C Madsen, DVM

  • Veterinarian
  • American Fork, UT
National Provider Identifier
1588906366
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
6226838-2802 Issued in UT
Practice address
582 W Pacific Dr
American Fork, UT 84003-1406
Phone
(801) 763-1900
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 6226838-2802 UT Primary

Addresses

Primary practice location

582 W Pacific Dr
American Fork, UT 84003-1406

Mailing address

582 W Pacific Dr
American Fork, UT 84003-1406
Phone (801) 763-1900

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6226838-2802UTMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1588906366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 W PACIFIC DR",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840031406",
            "telephone_number": "801-763-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 W PACIFIC DR",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840031406",
            "telephone_number": "801-763-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADSEN",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "UT",
            "license": "6226838-2802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.