Individual provider Active NPI

Mark Andrew Taylor, FNP-C

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1821784125
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11433571-4405 Issued in UT
Practice address
250 E 200 S FL 16
Salt Lake City, UT 84111-2472
Phone
(855) 775-1080
NPI assigned
Apr 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11433571-4405 UT Primary

Addresses

Primary practice location

250 E 200 S FL 16
Salt Lake City, UT 84111-2472

Mailing address

464 W 100 S Unit 8
Providence, UT 84332-6110
Phone (435) 554-9655

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230809002856 UT Practitioner - Nurse Practitioner 4486016318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health West IncGroup PAC ID 4981500931, 67 clinicians

Practice addresses (Care Compare)

1515 N 400
Suite 104
North Logan, UT 84341-7595
Phone (208) 232-7862

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bear Lake Community Health Center, Inc. CurrentSince Jul 15, 2023 Accepting new patients
Health West, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Health West, Inc. CurrentSince Jan 1, 2025 Accepting new patients
Health West, Inc. Past Accepting new patients

Locations

500 S 11th Ave
Ste 400
Pocatello, ID 83201

5 W 200 N
Brigham City, UT 84302
Phone (435) 723-6033

1515 N 400 E
Ste 104
North Logan, UT 84341
Phone (435) 755-8424

517 W 100 N
Ste 110
Providence, UT 84332
Phone (435) 213-4225

Interoperability endpoints

  • Direct secure messaging: mark.taylor.1@16258.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1821784125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 W 100 S UNIT 8",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843326110",
            "telephone_number": "435-554-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E 200 S FL 16",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841112472",
            "telephone_number": "855-775-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11433571-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.