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MARK KIMBALL GODDARD M.D.
NPI 1124101621
Internal Medicine - Critical Care Medicine in Murray, UT

Active since October 20, 2006PECOS Enrolled
5121 S. COTTONWOOD STREET, IMC, DIVISION OF PULMONARY/CCM, MURRAY, UT 84107(801) 507-4000 Get Directions Write a Review

NPPES record last updated: January 21, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mark Kimball Goddard M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK KIMBALL GODDARD M.D. (NPI 1124101621) is an individual critical care medicine provider in Murray, Utah, licensed in Utah (293990-1205) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124101621
Entity TypeIndividualMale
Primary Taxonomy207RC0200X
Provider Legal NameMARK KIMBALL GODDARDCredential: M.D.
Location Address5121 S. COTTONWOOD STREET, IMC, DIVISION OF PULMONARY/CCMMurray, UT 84107
Mailing Address5121 S. Cottonwood Street, Imc, Division Of Pulmonary/ccmMurray, UT 84123 · (801) 507-4000
Phone(801) 507-4000
Sole ProprietorNo
Enumeration DateOctober 20, 2006
Last NPPES UpdateJanuary 21, 2009
✔ NPI 1124101621 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RC0200X
Licenses✔ Licensed in UT · 293990-1205✔ Licensed in OR · MD26606✔ Licensed in WA · MD00046412
Definition

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.

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License MD26606 (OR), MD00046412 (WA), 293990-1205 (UT)
5121 S. COTTONWOOD STREET, Murray, UT 84107
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark Kimball Goddard M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.70 typical visit price
range $54.34 – $166.03
Typical copayment $31.42 (range $13.58 – $41.50)
Most-billed visit code 99204
Established Patient
$96.35 typical visit price
range $17.23 – $135.20
Typical copayment $24.08 (range $4.30 – $33.80)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Goddard's NPI number?

The NPI number for Mark Goddard is 1124101621. It was assigned to this individual provider in the NPPES registry on October 20, 2006.

Where is Mark Goddard located?

Mark Goddard practices at 5121 S. Cottonwood Street Imc, Division Of Pulmonary/Ccm, Murray, UT 84107. The listed phone number is (801) 507-4000.

What is Mark Goddard's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Critical Care Medicine, with taxonomy code 207RC0200X.

Is Mark Goddard enrolled in Medicare?

Yes. Mark Goddard is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mark Goddard was last updated on January 21, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.