GRANT A. FAIRBANKS, MD PC (NPI# 1891008777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891008777 |
Entity Type | Organization |
Organization Name | GRANT A. FAIRBANKS, MD PC |
Practice Address |
520 Medical Dr Suite 210 Bountiful UT 84010-4968 |
Mailing Address |
Po Box 1071 Bountiful UT 84011-1071 |
Practice Telephone | 8012688838 |
Mailing Telephone | 8017018688 |
Mailing Fax Number | 8017018689 |
Enumeration Date | 2010-07-20 |
Last Update Date | 2015-11-20 |
Authorized Official Name | GRANT A FAIRBANKS (PROVIDER) |
Authorized Official Telephone | 8017018688 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208200000X | Plastic Surgery | 2744901205 | UT | Allopathic & Osteopathic Physicians |
Street Address |
520 MEDICAL DR SUITE 210 |
City | BOUNTIFUL |
State | UT |
Zip Code | 84010-4968 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487655668 | Douglas Ray Coombs | Specialist | 520 Medical Dr, #301, Bountiful, UT 84010-4968 | 2005-08-10 |
1972952844 | Emily Daines | Nurse Practitioner | 520 Medical Dr, #301, Bountiful, UT 84010-4968 | 2016-06-10 |
1558633487 | Douglas R. Coombs, Md, Inc | Pediatrics | 520 Medical Dr, #301, Bountiful, UT 84010-4968 | 2012-02-08 |
1841421914 | Mount Ogden Eye Center | Clinic/Center | 520 Medical Dr, Ste 201, Bountiful, UT 84010-4968 | 2009-08-06 |
1124293808 | Bountiful Internal Medicine & Pulmonology Associates LLC | Internal Medicine | 520 Medical Dr, Suite 200, Bountiful, UT 84010-4968 | 2008-04-24 |
1194903328 | John B Lyman Md PC | Ophthalmology | 520 Medical Dr, Suite 201, Bountiful, UT 84010-4968 | 2008-02-11 |
1235340019 | Gina Markos Capps | Nurse Practitioner | 520 Medical Dr, Bountiful, UT 84010-4968 | 2007-05-24 |
1447478458 | Brian James Holdstock | Nurse Practitioner | 520 Medical Dr, Suite #301, Bountiful, UT 84010-4968 | 2007-04-23 |
1184840597 | G Richard Ellis | Physician Assistant | 520 Medical Dr, Suite #310, Bountiful, UT 84010-4968 | 2007-04-17 |
1255466447 | Ihc Health Services Inc | Dermatology | 520 Medical Dr, #320, Bountiful, UT 84010-4968 | 2007-02-21 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
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Taxonomy Code | 208200000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Plastic Surgery |
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073151536 | Christine A. Cheng Md PC | Plastic Surgery | 415 Medical Dr Ste D102, Bountiful, UT 84010-8906 | 2019-12-16 |
1851545081 | Premier Plastic Surgery Group of Utah, LLC | Plastic Surgery | 1551 Renaissance Towne Dr, Suite 360, Bountiful, UT 84010-7675 | 2008-11-14 |
1700952231 | Joseph Gregory Kjar | Plastic Surgery | 415 Medical Dr, Ste #b-200, Bountiful, UT 84010-4946 | 2006-11-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518591874 | Slc Plastic Surgery LLC | Plastic Surgery | 6686 Highland Drive, Cottonwood Heights, UT 84121 | 2020-02-26 |
1477016079 | Teresa Zavala | Plastic Surgery | 6169 W Ridge Mesa Cir, West Valley City, UT 84128-5638 | 2019-04-10 |
1477041101 | Cranio Ninja LLC | Plastic Surgery | 1055 N 300 W Ste 301, Provo, UT 84604-3373 | 2018-04-27 |
1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
1841736501 | Refine The Body Inc | Plastic Surgery | 1300 N 500 E Ste 260, Logan, UT 84341-2417 | 2017-01-18 |
1720320179 | Melody Scheefer Van Boerum | Plastic Surgery | 5445 S Highland Dr, Salt Lake City, UT 84117-7629 | 2013-03-25 |
1508156928 | Richard Tyrell | Plastic Surgery | 30 N 1900 E Rm 3b400, Salt Lake City, UT 84132-0002 | 2011-04-19 |
1194015693 | Jeremy Robert Chidester | Plastic Surgery | 11762 S State St Ste 333, Draper, UT 84020-7166 | 2011-04-18 |
1851617815 | Dana Nicole Johns | Plastic Surgery | University of Utah Hospital 50 N Medical Dr, Salt Lake City, UT 84132-0002 | 2010-04-15 |
1760705594 | Craig Davis | Plastic Surgery | 3163 N Grasslands Pkwy, Washington, UT 84780-2097 | 2010-03-08 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.