Mark R Johnson MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

184901-1205 Issued in UT

Legal business name

MARK R JOHNSON MD PC

Practice address

1899 E Siesta Dr
Cottonwood Heights, UT 84093-6241

Phone

(850) 163-1821

NPI assigned

Jun 16, 2015

Organization subpart

Yes

Parent organization

KADENCE TECHNOLOGY, INCAs reported in NPPES

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

Authorized official

Name

Mark R Johnson, MD

Title

Sole Member

Phone

(801) 631-8210

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1740661792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110307",
            "telephone_number": "801-294-6907",
            "fax_number": "801-294-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 E SIESTA DR",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "840936241",
            "telephone_number": "850-163-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R JOHNSON MD PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KADENCE TECHNOLOGY, INC",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "801-631-8210",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "184901-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly A Mangrum, D.D.S.
• Dave Mangum, CMHC
• Ashley Jane Mann
• Jessica Xaiz Mann, LCSW
• Benjamin James Marden
• Mark Rolfe Johnson MD., P.C.
• Madeline Marple
• Haley Marston
• Alison Elaine Martin, PHARMD
• Denise Martinez Gascoigne, MS, RD, CN

• Internal Medicine Physician in Cottonwood Heights, UT
• Providers in Cottonwood Heights, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.