MARK KIMBALL GODDARD M.D. NPI 1124101621

NPI Information

  • NPI: 1124101621
  • Provider Name: MARK KIMBALL GODDARD, M.D.
  • Classification: Internal Medicine - 207RC0200X
  • Specialization: Critical Care Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5121 S. COTTONWOOD STREET
    IMC, DIVISION OF PULMONARY/CCM
    MURRAY, UT
    ZIP 84107
  • Phone: (801) 507-4000

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NPI Details

Mark Kimball Goddard, M.D. is a critical care medicine internal medicine in Murray, UT. The provider is an internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. Mark Kimball Goddard, M.D. NPI is 1124101621. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5121 S. COTTONWOOD STREET
IMC, DIVISION OF PULMONARY/CCM
MURRAY, UT
ZIP 84107
Phone: (801) 507-4000

The NPI 1124101621 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 10/20/2006 and was last updated on 1/21/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0200XInternal MedicineCritical Care MedicineMD26606OREGONNo
2207RC0200XInternal MedicineCritical Care MedicineMD00046412WASHINGTONNo
3207RP1001XInternal MedicinePulmonary DiseaseMD26606OREGONNo
4207RP1001XInternal MedicinePulmonary DiseaseMD00046412WASHINGTONNo
5207RP1001XInternal MedicinePulmonary Disease293990-1205UTAHNo
6207RC0200XInternal MedicineCritical Care Medicine293990-1205UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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