MARK KENNETH BENNETT


Address: 4403 Harrison Blvd, Suite 1815, Ogden, UT 84403-3339
Phone: 8013876520

MARK KENNETH BENNETT (NPI# 1871859223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871859223
Entity Type Individual
Full Name MARK KENNETH BENNETT
Credential PA-C
Practice Address 4403 Harrison Blvd
Suite 1815
Ogden
UT 84403-3339
Mailing Address Po Box 5546
Denver
CO 80217-5546
Practice Telephone 8013876520
Practice Fax Number 8013876525
Mailing Telephone 8014753481
Enumeration Date 2012-04-10
Last Update Date 2019-09-09
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363AM0700X Physician Assistant
Specialization: Medical
8134401-8906 UT Physician Assistants & Advanced Practice Nursing Providers
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
8134401-1206 UT Physician Assistants & Advanced Practice Nursing Providers

Other Providers MARK BENNETT

NPI Name Taxonomy Address Enumeration
1871912287 Mark Bennett Counselor 829 27th St, San Diego, CA 92102-2710 2014-04-14
1811104771 Mark Andrew Bennett Chiropractor Valley Plaza Rt. 7, Suite 4, Reedsville, WV 26547 2007-05-17
1528168952 Mark David Bennett Pharmacist 206 North Charlotte Street, Pottstown, PA 19464 2006-09-25
1861467599 Mark Daniel Bennett Optometrist 1839 Briargate Blvd, Colorado Springs, CO 80920-3470 2006-02-17
1255327623 Mark Thomas Bennett Chiropractor 5031 E Orangethorpe Ave, Suite H, Anaheim, CA 92807-1131 2005-09-21
1073031340 Mark Allen Bennett Counselor 166 Broadway, Bangor, ME 04401-5208 2017-09-06
1518403724 Mark Andrew Bennett Pharmacist 1200 S Commerce Way, Brigham City, UT 84302-3117 2017-01-11
1871955435 Mark Richard Bennett Jr. Nurse Anesthetist, Certified Registered 709 W Main St, Manchester, IA 52057-1526 2016-03-23
1245609817 Mark Bennett Nursing Care 2766 W 11 Mile Rd Ste 2, Berkley, MI 48072-3033 2015-09-24
1306273784 Mark Barry Bennett Social Worker 2275 W Broadway St, Ste G, Idaho Falls, ID 83402-2902 2013-10-01

Office Location

Street Address 4403 HARRISON BLVD
SUITE 1815
City OGDEN
State UT
Zip Code 84403-3339

Providers in the same location

NPI Name Taxonomy Address Enumeration
1518962794 Fred George Seale Iv Obstetrics & Gynecology 4403 Harrison Blvd, Ste 4650, Ogden, UT 84403-3271 2005-06-15
1720502859 Derek Smith Physician Assistant 4403 Harrison Blvd, Ogden, UT 84403-3271 2017-07-31
1245766393 Jacob Saunders Student in an Organized Health Care Education/Training Program 4403 Harrison Blvd, Suite A-700, Ogden, UT 84403-3271 2017-05-11
1043746191 Haleigh Emerson Family Medicine 4403 Harrison Blvd, Suite A700, Ogden, UT 84403-3271 2017-05-11
1457887507 Madison Beatty Student in an Organized Health Care Education/Training Program 4403 Harrison Blvd, Suite A700, Ogden, UT 84403 2017-05-11
1669908711 Spencer Ruben Student in an Organized Health Care Education/Training Program 4403 Harrison Blvd, Suite A700, Ogden, UT 84403-3271 2017-05-11
1376083147 Linda Maria Jones Nurse Practitioner 4403 Harrison Blvd, Suite 3490, Ogden, UT 84403 2017-02-27
1114376431 Jonas Legrand Peterson Family Medicine 4403 Harrison Blvd, Suite A-700, Ogden, UT 84403-3271 2016-06-07
1649629965 Derek Paul Wille Family Medicine 4403 Harrison Blvd, Suite A-700, Ogden, UT 84403-3271 2016-06-07
1467838086 Brandy Millward Social Worker 4403 Harrison Blvd, Suite 3630, Ogden, UT 84403-3271 2015-08-05
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235744632 Megan Louise Larkins Specialist/Technologist 4000 Brinker Ave. The Apartments., Apartment 15, Ogden, UT 84403 2020-09-11
1154959062 Joshua Clifford Hansen Student in an Organized Health Care Education/Training Program 4403 Harrison Boulevard, Ste A700, Ogden, UT 84403 2020-03-28
1346895935 Positional Release Therapy Institute LLC Specialist/Technologist 1702 E. 5600 S., Ogden, UT 84403 2019-08-09
1841842077 Braken Wooden Chiropractor 1893 Skyline Dr., Suite 204, South Ogden, UT 84403 2019-07-09
1023670569 Wasatch Advanced Dental Care LLC Dentist 3590 Harrison Blvd Suite #1, Ogden, UT 84403 2019-07-05
1194237636 Marci Niemeyer Physician Assistant 5929 Fashion Point Dr Ste 101, South Ogden, UT 84403 2017-10-24
1578081949 Stephanie Jensen Specialist/Technologist 1473 36th Street, Ogden, UT 84403 2017-09-06
1891213385 Forrest Sutherland Specialist/Technologist 1075 E 41st St., Ogden, UT 84403 2017-09-05
1184159022 Nicole Lee Van Tassell In Home Supportive Care 1496 East 5600 South, Unit 6, Ogden, UT 84403 2017-04-28
1265889166 Modern Dental Professionals Ut, PC Dentist 5974 S. Fashion Pointe Drive, Suite 210, South Ogden, UT 84403 2016-05-20
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407074461 Richard Dix Cloward Physician Assistant 4403 Harrison Blvd Ste 4400, Ogden, UT 84403-3290 2007-04-23
1871094177 Brittney Kimiko Taylor Physician Assistant 5475 S 500 E, Ogden, UT 84405-6905 2018-02-22
1407296809 Brett Ronald Dille Physician Assistant 4403 Harrison Blvd, #2400, Ogden, UT 84403-3271 2013-06-28
1154413235 Kenneth Allen Garcia Physician Assistant 2240 Adams Ave, Ogden, UT 84401-1511 2006-09-28

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1649892829 Van Martin Stonehocker Physician Assistant 755 W Center St, Orem, UT 84057-5365 2020-05-11
1366004517 Brock Bodily Physician Assistant 10623 S Redwood Rd # 101, South Jordan, UT 84095-2481 2019-07-08
1891230041 Sarah Danielle Mendenhall Physician Assistant 5169 S Cottonwood St Ste 600, Murray, UT 84107-6771 2016-12-26
1104284124 Amanda Cummings Physician Assistant 30 N 1900 E # 3b110, Salt Lake City, UT 84132-0002 2016-02-04
1043699101 Chris Anderson Physician Assistant 30 North 1900 East #3c344, Salt Lake City, UT 84132 2015-05-22
1861895344 Ariel Black Physician Assistant 30 N 1900 E # 3c344, Salt Lake City, UT 84132-0002 2014-09-29
1336493709 Monica L Hatch Physician Assistant 2132 N 1700 W Ste 200, Layton, UT 84041-7060 2012-11-06
1912130311 Andrew M Strong Physician Assistant 5323 Woodrow St Ste 202, Salt Lake City, UT 84107-5848 2009-09-01
1164666061 Stephen A Loper Physician Assistant 1055 N 500 W Ste 211, Provo, UT 84604-3305 2009-04-23
1982869210 Scott D Taylor Physician Assistant 5323 Woodrow St Ste 102, Murray, UT 84107-5853 2008-07-25
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Competitor

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City OGDEN
Zip Code 84403

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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