DR. MARK ELLIS (NPI# 1972897080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972897080 |
| Entity Type | Individual |
| Full Name | DR. MARK ELLIS |
| Credential | DPM |
| Practice Address |
12592 S 150 E Draper UT 84020-8611 |
| Mailing Address |
5994 S Hospital Dr Globe AZ 85501-9462 |
| Practice Telephone | 7133772167 |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2018-05-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 213EP0504X |
Podiatrist Specialization: Public Medicine |
10105797-0501 | UT | Podiatric Medicine & Surgery Service Providers |
| N | 213ER0200X |
Podiatrist Specialization: Radiology |
10105797-0501 | UT | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0000X |
Podiatrist Specialization: Sports Medicine |
10105797-0501 | UT | Podiatric Medicine & Surgery Service Providers |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
0821 | AZ | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
10105797-0501 | UT | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659682219 | Mark Kenneth Ellis | Emergency Medicine | 2 5th Ave Apt 2d, New York, NY 10011-8832 | 2010-06-29 |
| 1174661672 | Mark Joseph Ellis | Chiropractor | 41 Western Avenue, Rochester, NH 03867 | 2007-02-05 |
| 1336204171 | Mark J Ellis | Respiratory Therapist, Certified | 1101 Jefferson Blvd, Hagerstown, MD 21742-5037 | 2006-12-22 |
| 1184719262 | Mark Allen Ellis | Dentist | 910 Averitt Rd, Greenwood, IN 46143-9540 | 2006-10-04 |
| 1437240124 | Mark Owen Ellis | Podiatrist | 582 22nd Street, Astoria, OR 97103 | 2006-09-27 |
| 1083632244 | Mark Brian Ellis | Family Medicine | 1018 Rucker Blvd, Ste A, Enterprise, AL 36330-3675 | 2006-07-17 |
| 1265426894 | Mark Alan Ellis | Dentist | 951 Riverfront Pkwy, Suite 302, Chattanooga, TN 37402-2185 | 2005-09-09 |
| 1316580509 | Mark Duane Ellis | Licensed Practical Nurse | 2600 Se Belmont St, Portland, OR 97214-2916 | 2019-10-21 |
| 1629427752 | Mark Andrew Ellis | Otolaryngology | 169 Ashley Ave, Room 202 Main Hospital, Msc 333, Charleston, SC 29425-9080 | 2016-06-09 |
| 1366808677 | Mark Ellis | Behavioral Analyst | 453 King St, Cocoa, FL 32922-7621 | 2016-01-04 |
| Street Address |
12592 S 150 E |
| City | DRAPER |
| State | UT |
| Zip Code | 84020-8611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306388400 | Brenderlin Health LLC | Podiatrist | 12592 S 150 E, Draper, UT 84020-8611 | 2016-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
| 1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
| 1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
| 1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
| 1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
| 1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
| 1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
| 1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
| 1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
| 1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
| Find all providers in zip 84020 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306388400 | Brenderlin Health LLC | Podiatrist | 12592 S 150 E, Draper, UT 84020-8611 | 2016-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033721303 | Stride Foot and Ankle Pllc | Podiatrist | 1365 W 1250 S Ste 101, Orem, UT 84058-2303 | 2020-08-18 |
| 1700369014 | Utah Podiatry Group PC | Podiatrist | 6321 S Redwood Rd Ste 102, Taylorsville, UT 84123-6799 | 2018-09-12 |
| 1457847964 | Utah Podiatry Group PC | Podiatrist | 24 S 1100 E Ste 120, Salt Lake City, UT 84102 | 2018-07-09 |
| 1700384930 | Utah Podiatry Group PC | Podiatrist | 82 S 1100 E Ste 301, Salt Lake City, UT 84102 | 2018-01-23 |
| 1447773122 | Apex Foot and Ankle Institute | Podiatrist | 882 N Main St # 2, Richfield, UT 84701-1840 | 2017-07-25 |
| 1902328644 | Weston Charles Packard | Podiatrist | 1561 W 7000 S Ste 201, West Jordan, UT 84084-3556 | 2017-07-14 |
| 1053844753 | Elite Ankle and Foot Pllc | Podiatrist | 39 E Center Street, Gunnison, UT 84634 | 2017-04-10 |
| 1811341621 | Victor Kent Myers | Podiatrist | 754 S Main St Ste 3, St George, UT 84770-5505 | 2016-04-18 |
| 1598119463 | Landon Cameron | Podiatrist | 1490 E Foremaster Dr Ste 250, St George, UT 84790-4501 | 2016-04-18 |
| 1417338161 | Adam Bowen Wood | Podiatrist | 1248 E 90 N Ste 101, American Fork, UT 84003-2954 | 2015-06-17 |
| Find all providers with the same taxonomy | ||||
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| 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.