Mark Jacob Sorensen, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4265 Issued in MT

Practice address

75 Claremont St
Suite B
Kalispell, MT 59901-3585

Phone

(406) 752-2277

Fax

(406) 752-5029

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841219193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CLAREMONT ST",
            "address_2": "SUITE B",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013585",
            "telephone_number": "406-752-2277",
            "fax_number": "406-752-5029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 CLAREMONT ST",
            "address_2": "SUITE B",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599013585",
            "telephone_number": "406-752-2277",
            "fax_number": "406-752-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "MARK",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "4265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "810375497 59901 A001",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0050882",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MONTANA",
            "identifier": "12270",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Pediatrics Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.