Kathleen Mark, CNM is a medicare enrolled "Midwife" in South Ogden, Utah. Her current practice location is
1525 East 6000 South, South Ogden, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 337-5800.
Kathleen Mark is licensed to practice in Utah (license number 1924744402) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1851314389.
Provider's Profile
| Full Name | Kathleen Mark |
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| Gender | Female |
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| Speciality | Midwife |
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| Location | 1525 East 6000 South, South Ogden, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1851314389
- Provider Enumeration Date: 07/25/2006
- Last Update Date: 08/13/2009
Medicare PECOS Information:
- PECOS PAC ID: 3870571227
- Enrollment ID: I20040712000711
Medical Identifiers
Medical identifiers for Kathleen Mark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1851314389 | NPI | - | NPPES |
| D0895 | Medicaid | UT | |
| 160009437 | Other | UT | MEDICARE RAILROAD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367A00000X | Advanced Practice Midwife | 192474-4402 (Utah) | Secondary |
| 176B00000X | Midwife | 1924744402 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kathleen Mark allows following entities to bill medicare on her behalf.
| Entity Name | Circle of Life Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1548284078
PECOS PAC ID: 5193703544
Enrollment ID: O20040712000677 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kathleen Mark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kathleen Mark, CNM
1525 East 6000 South,
South Ogden, UT 84405
Ph: (801) 337-5800 | Kathleen Mark, CNM
1525 East 6000 South,
South Ogden, UT 84405
Ph: (801) 337-5800 |
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