| St. Mark's Family Medicine | |
|
1250 E 3900 S Suite 260 Salt Lake City UT 84124-1348 | |
| (801) 265-2000 | |
| (801) 265-2008 |
| Full Name | St. Mark's Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1250 E 3900 S, Salt Lake City, Utah |
| Authorized Official Name and Position | John Berneike (DIRECTOR/OFFICER) |
| Authorized Official Contact | 8012652000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Mark's Family Medicine 1250 E 3900 S Suite 260 Salt Lake City UT 84124-1348 Ph: (801) 265-2000 | St. Mark's Family Medicine 1250 E 3900 S Suite 260 Salt Lake City UT 84124-1348 Ph: (801) 265-2000 |
| NPI Number | 1376597344 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 12/07/2016 |
| Medicare PECOS PAC ID | 7719882562 |
|---|---|
| Medicare Enrollment ID | O20031204000492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376597344 | NPI | - | NPPES |
| 1376597344 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Camille Collett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275530305 PECOS PAC ID: 9335189026 Enrollment ID: I20050512000312 |
| Provider Name | John A Berneike |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982688321 PECOS PAC ID: 3971544677 Enrollment ID: I20050512000483 |
| Provider Name | Richard E Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831174226 PECOS PAC ID: 4981633724 Enrollment ID: I20050811000508 |
| Provider Name | Karl A Kirby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912955402 PECOS PAC ID: 2163447574 Enrollment ID: I20090727000282 |
| Provider Name | Paula Jane Cook |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922209386 PECOS PAC ID: 7618015157 Enrollment ID: I20091103000706 |
| Provider Name | Leslie Hardin Rassner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427022938 PECOS PAC ID: 4880878198 Enrollment ID: I20110412000293 |
| Provider Name | Allison M Seavey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881825966 PECOS PAC ID: 2466685474 Enrollment ID: I20140428001632 |
| Provider Name | Diane K Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255715710 PECOS PAC ID: 9537476270 Enrollment ID: I20150914001664 |
| Provider Name | John Benjamin Dame |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922205947 PECOS PAC ID: 1456445618 Enrollment ID: I20160601002995 |
| Provider Name | Rosemarie Linsler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144776089 PECOS PAC ID: 6709165889 Enrollment ID: I20161111001944 |
| Provider Name | Sean D Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497142582 PECOS PAC ID: 1951609544 Enrollment ID: I20180601002320 |
| Provider Name | Jordan Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588043871 PECOS PAC ID: 8426354994 Enrollment ID: I20180611001538 |
| Provider Name | Zoe Kathleen Cross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770945834 PECOS PAC ID: 3072889500 Enrollment ID: I20190702000998 |
| Provider Name | Hilary G Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841888211 PECOS PAC ID: 1153728209 Enrollment ID: I20210916001961 |
| Provider Name | Madeline Marie Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437773751 PECOS PAC ID: 3779973961 Enrollment ID: I20211202000199 |
| Provider Name | Melanie Ann Dance |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013160597 PECOS PAC ID: 4688091192 Enrollment ID: I20220517002920 |
| Provider Name | Danielle Kfoury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427633817 PECOS PAC ID: 4587053277 Enrollment ID: I20220720000042 |
| Provider Name | Kevin Donner Swanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649732322 PECOS PAC ID: 3476973983 Enrollment ID: I20220922003279 |
| Provider Name | Collin T. Lash |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285261487 PECOS PAC ID: 1355746330 Enrollment ID: I20230914000973 |
| Provider Name | Kaitlin Diane Connolly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932839727 PECOS PAC ID: 3779937057 Enrollment ID: I20230921000725 |
| Provider Name | Maryana Carole Boulos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598325821 PECOS PAC ID: 3476909938 Enrollment ID: I20231019003596 |
| Provider Name | Jourdan Johnson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1871086140 PECOS PAC ID: 0244675734 Enrollment ID: I20240223001825 |
Ted R Schultz Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 866 Padley St, Salt Lake City, UT 84108 Phone: 801-202-4892 | |
Intermountain Healthcare Flu Shot Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 776 N Terminal Dr, Salt Lake City, UT 84122 Phone: 801-292-6100 | |
U-u Pulmonary Division Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 N Medical Dr, Salt Lake City, UT 84132 Phone: 801-581-2121 | |
Ldsh Cancer Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 370 9th Ave, Salt Lake City, UT 84103 Phone: 801-442-1400 | |
Bmt Division Department Of University Of Utah Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1950 Circle Of Hope Dr, Salt Lake City, UT 84112 Phone: 801-581-2121 | |
All For Women Healthcare, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2605 E 3300 S, Salt Lake City, UT 84109 Phone: 801-746-7467 Fax: 801-746-7469 | |
University Of Utah Hospital Infectious Disease Division Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 N Medical Dr, Salt Lake City, UT 84132 Phone: 801-587-6336 |