Individual provider Active NPI

Mack Tarver

  • Social Worker
  • Salt Lake City, UT
National Provider Identifier
1801300520
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1370 S West Temple
Salt Lake City, UT 84115-5218
Phone
(801) 678-3317
NPI assigned
Nov 17, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

1370 S West Temple
Salt Lake City, UT 84115-5218

Mailing address

235 E Rigdon Ave
Salt Lake City, UT 84115-4818
Phone (801) 718-5881

Other practice location 1

1370 S West Temple
Salt Lake City, UT 84115-5218
Phone (801) 678-3317

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

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1801300520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E RIGDON AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841154818",
            "telephone_number": "801-718-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 S WEST TEMPLE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841155218",
            "telephone_number": "801-678-3317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1370 S West Temple",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841155218",
            "country_code": "US",
            "telephone_number": "801-678-3317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARVER",
        "first_name": "MACK",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.