Individual provider Active NPI

Mark Nebeker, PHARMD

  • Pharmacist
  • St George, UT
National Provider Identifier
1730722091
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
6683586-1701 Issued in UT
Practice address
565 S Mall Dr
St George, UT 84790-1258
Phone
(435) 705-7420
Fax
(435) 705-7421
NPI assigned
Oct 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18058 NV
Pharmacist 183500000X 6683586-1701 UT Primary

Addresses

Primary practice location

565 S Mall Dr
St George, UT 84790-1258

Mailing address

86 E Fort Knox Way
Washington, UT 84780-4708

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
18058NVMDPharmacist
6683586-1701UTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Smiths Food & Drug Centers Inc PastSince Oct 20, 2019 Accepting new patients
Smith'S Food & Drug Centers Inc PastSince Oct 20, 2019 Accepting new patients

Organizations & group practices 2

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": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1730722091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 E FORT KNOX WAY",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847804708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 S MALL DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847901258",
            "telephone_number": "435-705-7420",
            "fax_number": "435-705-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEBEKER",
        "first_name": "MARK",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "18058",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "6683586-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.