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MA BO INC
NPI 1275182487
Family Medicine in Salt Lake City, UT

Active since September 10, 2019CLIA 46D2010206 · Waiver
522 E 100 S, SALT LAKE CITY, UT 84102(801) 485-5055(801) 467-3296 Get Directions Write a Review

NPPES record last updated: September 10, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ma Bo Inc NPPES

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

MA BO INC (NPI 1275182487) is a healthcare organization registered as a family medicine in Salt Lake City, Utah and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through July 21, 2028 and lists Caitlin Danielle Cacciatore, Office Administrator, as its authorized official.

NPPES Registry Identity

NPI1275182487
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMA BO INC
Location Address522 E 100 SSalt Lake City, UT 84102-1905
Mailing Address522 E 100 SSalt Lake City, UT 84102-1905 · (801) 485-5055 · Fax (801) 467-3296
Phone(801) 485-5055
Fax(801) 467-3296
Organization SubpartYes
Authorized OfficialCaitlin Danielle CacciatoreOffice Administrator · (801) 485-5055
Enumeration DateSeptember 10, 2019
✔ NPI 1275182487 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
522 E 100 S, Salt Lake City, UT 84102
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2010206

Ma Bo PC Dba House Call Doctors · Salt Lake City, UT
Active · expires Jul 21, 2028
CLIA Number46D2010206
Laboratory TypeMobile Laboratory
Certificate Effective DateJuly 22, 2026
Certificate Expiration DateJuly 21, 2028
Laboratory DirectorMark J. Cacciamani
Laboratory Phone(801) 485-5055
Laboratory LocationMa Bo PC Dba House Call Doctors466 East 500 South, Suite 200, Salt Lake City, UT 84111
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

SANDRA BETHEL JENSE APRN
Nurse Practitioner (Acute Care)
522 E 100 S
SALT LAKE CITY, UT 84102
Salt Lake County (801) 485-5055
MRS. MERCEDES LONGSHAW MORTENSEN AGNP-C
Nurse Practitioner (Gerontology)
522 E 100 S
SALT LAKE CITY, UT 84102
Salt Lake County (801) 485-5055
MRS. COURTNEY HARPER PA-C
Physician Assistant
522 E 100 S
SALT LAKE CITY, UT 84102
Salt Lake County (801) 485-5055
KAREN FRONK AGNP, BSN, RN
Nurse Practitioner (Adult Health)
522 E 100 S
SALT LAKE CITY, UT 84102
Salt Lake County (801) 485-5055

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 Ma Bo Inc's NPI number?

The NPI number for Ma Bo Inc is 1275182487. It was assigned to this organization in the NPPES registry on September 10, 2019.

Where is Ma Bo Inc located?

Ma Bo Inc is located at 522 E 100 S, Salt Lake City, UT 84102. The listed phone number is (801) 485-5055.

What is Ma Bo Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Ma Bo Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2010206) is associated with this NPI, valid through July 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ma Bo Inc was last updated on September 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.