Active NPI
Mark Eric Beese, ATC, LAT
- Specialist
- Salt Lake City, UT
National Provider Identifier
1992163166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 7726414-4810
- Practice address
- 590 S Wakara Way
Salt Lake City, UT 84108-1200 - Phone
- (801) 587-1473
- Fax
- (801) 587-7115
- NPI assigned
- Feb 3, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 7726414-4810 | UT | Primary |
Addresses
Primary practice location
590 S Wakara Way
Salt Lake City, UT 84108-1200
Mailing address
580 Wakara Way
Salt Lake City, UT 84108
Phone (801) 587-1473
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7726414-4810 | UT | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1992163166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "580 WAKARA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84108",
"telephone_number": "801-587-1473",
"fax_number": "801-587-7115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 S WAKARA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081200",
"telephone_number": "801-587-1473",
"fax_number": "801-587-7115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEESE",
"first_name": "MARK",
"middle_name": "ERIC",
"name_prefix": "Mr.",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-02-03",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "UT",
"license": "7726414-4810",
"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 Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.