ST. MARK'S GYNECOLOGY ONCOLOGY CARE LLC – NPI #1053593921
Obstetrics & Gynecology

An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.

ST. MARK'S GYNECOLOGY ONCOLOGY CARE LLC is a provider located in SALT LAKE CITY, UT. NPPES has assigned the NPI number 1053593921 to ST. MARK'S GYNECOLOGY ONCOLOGY CARE LLC on December 03, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207VX0201X from the Health Care Provider Taxonomy code set, which is classified as Obstetrics & Gynecology, specializing in Gynecologic Oncology

The NPI profile was previously updated about 3 years ago on Aug 29, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ST. MARK'S GYNECOLOGY ONCOLOGY CARE LLC below.

NPI Profile for
ST. MARK'S GYNECOLOGY ONCOLOGY CARE LLC

NPI Number
1053593921
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ST. MARK'S GYNECOLOGY ONCOLOGY CARE LLC
Primary location
1140 E 3900 S STE 400
SALT LAKE CITY, UT 84124-1269
Phone: (801) 268-6811 Fax: (801) 743-4736
Mailing address
2000 HEALTH PARK DR
BRENTWOOD, TN 37027-4525
Phone: (615) 373-7406 Fax: (866) 346-1426
Organization Subpart
No
Authorized Official
LOUIS JOSEPH
VP
Phone: (615) 373-7630
Updated
Certification Date
Aug 29, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for ST. MARK'S GYNECOLOGY ONCOLOGY CARE LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidID807953700
medicaidUT1053593921
medicaidWY1053593921
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207VX0201X
- Obstetrics & Gynecology / Gynecologic Oncology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.