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MARK ROLAND NICKLE FNP
NPI 1134769342
Nurse Practitioner - Family in Roy, UT

Active since January 15, 2020

NPPES record last updated: May 27, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 27, 2021, Mar 25, 2021, Jan 15, 2020 (3 updates tracked since 2020).

About Mark Roland Nickle Fnp NPPES

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

MARK ROLAND NICKLE FNP (NPI 1134769342) is an individual family provider in Roy, Utah, licensed in Utah (6234684-4405) and active in the NPI registry since January 2020. He maintains a secondary practice location in South Salt Lake.

NPPES Registry Identity

NPI1134769342
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameMARK ROLAND NICKLECredential: FNP
Location Address5305 S 1900 WRoy, UT 84067-2906
Mailing Address249 S 1050 ELayton, UT 84041-4499 · (801) 663-3126
Phone(801) 825-5648
Sole ProprietorYes
Enumeration DateJanuary 15, 2020
Last NPPES UpdateMay 27, 20213 updates tracked since enumeration
NPPES CertifiedMay 27, 2021
✔ NPI 1134769342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in UT · 6234684-4405
Also ListedNurse PractitionerTaxonomy 363L00000X · License 6234684-4405 (UT)
5305 S 1900 W, Roy, UT 84067
Open in Google Maps ↗

Secondary Practice Location 1

Location 13702 S State St Ste 107South Salt Lake, UT 84115-5096 · Phone (801) 288-2634 · Fax (801) 288-1186

Other Identifiers 1

Medicaid1134769342UT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, Select Health.Insurance ›

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
84 services49 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
39 services28 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
30 services24 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
28 services28 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
22 services20 patients
Dialysis services, 1 physician visit per month (20 years or older) 90962
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can’t do their job. A physician visit once a month ensures your treatment is working effectively and adjusts it if necessary. This service is available for individuals aged 20 years and older.
19 services16 patients

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMIE GLEASON
Pharmacist
5305 S 1900 W
ROY, UT 84067
Weber County (801) 825-5648
SABINA LYNN WAYMENT PHARMD
Pharmacist
5305 S 1900 W
ROY, UT 84067
Weber County (801) 825-5648
UTAH CVS PHARMACY, L.L.C.
Pharmacy
5305 S 1900 W
ROY, UT 84067
Weber County (801) 825-5648

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 Nickle's NPI number?

The NPI number for Mark Nickle is 1134769342. It was assigned to this individual provider in the NPPES registry on January 15, 2020.

Where is Mark Nickle located?

Mark Nickle practices at 5305 S 1900 W, Roy, UT 84067. The listed phone number is (801) 825-5648.

What is Mark Nickle's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

What insurance does Mark Nickle accept?

Health plans from Molina Healthcare and Select Health list Mark Nickle as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Nickle was last updated on May 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.