Mark Thain Evans, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

17800 Camp Williams Rd
BLDG 9000 Suite 200
Riverton, UT 84065-4905

Phone

(801) 523-4406

NPI assigned

May 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• University Primary Care Sports Med

  • Sports Medicine (Family Medicine) Physician
  • Salt Lake City, UT
  • NPI 1699796706
  NPD (past)

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861606154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 W 6TH AVE",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840477380",
            "telephone_number": "081-352-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 CAMP WILLIAMS RD",
            "address_2": "BLDG 9000 SUITE 200",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840654905",
            "telephone_number": "801-523-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MARK",
        "middle_name": "THAIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric E. Martin, DDS, PC
• Kimberly Michelle Erickson, MS, CCC-SLP; WDP
• Rachel Julene Erickson
• Kristina D Esham, MD
• Kenzie Cierra Evans
• Cicely Fabiano, DPT
• Families First Orthodontics
• Families First Pediatric Dentistry
• Families First Pediatrics
• Brittany Nicole Favero

• Physician Assistant in Riverton, UT
• Providers in Riverton, UT by specialty
• Physician Assistant in Utah

• 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.