FJM BASECAMP (NPI# 1255858734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255858734 |
| Entity Type | Organization |
| Organization Name | FJM BASECAMP |
| Other Organization Name | FJM MEDICAL CLINIC-BASECAMP |
| Practice Address |
185 S State St Ste 208 Salt Lake City UT 84111-1558 |
| Mailing Address |
560 S 300 E Ste 275 Salt Lake City UT 84111-3586 |
| Practice Telephone | (801) 821-5454 |
| Practice Fax Number | 8018215455 |
| Mailing Telephone | 8014411002 |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2020-01-30 |
| Authorized Official Name | DARCE A LATSIS (OPERATIONS MANAGER) |
| Authorized Official Telephone | 8014411002 |
| Is Organization Subpart | Y |
| Parent Organization Name | FUTURA MEDICAL CLINIC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 70786441205 | UT | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| FJM Medical Clinic-BaseCamp | Doing Business As Name - Organization |
| Street Address |
185 S STATE ST STE 208 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84111-1558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316551336 | Mary Ann Rush | Case Manager/Care Coordinator | 334 E. 100 S., Slc, UT 84111 | 2020-09-08 |
| 1790396554 | Stephanie G Mishenko | Military Health Care Provider | 344e 100s, Slc, UT 84111 | 2020-08-13 |
| 1386264802 | Mckensee M Carter | Case Manager/Care Coordinator | 334 E 100 S, Salt Lake City, UT 84111 | 2020-04-24 |
| 1316421761 | Community Health Centers, Inc. | Social Worker | 610 S 200 E Ste #b, Salt Lake City, UT 84111 | 2018-09-21 |
| 1528545506 | Lauren Brittney Harman | Case Manager/Care Coordinator | 344 E. 100 S., Salt Lake City, UT 84111 | 2018-07-23 |
| 1851896484 | Shivani Chowdhary | Dentist | 370 E South Temple Ste 350, Salt Lake City, UT 84111 | 2018-03-26 |
| 1801390661 | Jaylee Marie Watman | Case Manager/Care Coordinator | 344 E. 100 S. Ste 301, Salt Lake City, UT 84111 | 2018-03-19 |
| 1467963918 | Victoira Julia Graham | Case Management | 344 East 100 South Ste 301, Salt Lake City, UT 84111 | 2017-10-23 |
| 1750805404 | Kayla Hymas | Behavioral Analyst | 243 E. 400 S., Slc, UT 84111 | 2017-08-02 |
| 1134643224 | Julie Peaslee | Counselor | 275 E South Temple Ste 110, Salt Lake City, UT 84111 | 2017-07-31 |
| Find all providers in zip 84111 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356957468 | Aubrie Dawn Tilley | Family Medicine | 1741 E Imperial Park Ln, Salt Lake City, UT 84106-3379 | 2020-09-23 |
| 1457969834 | Sandra Lee Porter | Family Medicine | 3979 S Jester Dr, Salt Lake City, UT 84123-1227 | 2020-07-21 |
| 1265057673 | Onsite Care Clinics | Family Medicine | 230 S 500 E Ste 510, Salt Lake City, UT 84102-2028 | 2020-06-11 |
| 1467097071 | Centric Physicians Intermountain Region, Pllc | Family Medicine | 7101 N Mesa Street #365, Salt Lake City, UT 84101-1603 | 2019-11-07 |
| 1760036024 | Mindy Marie Wade | Family Medicine | 1950 E Fort Union Blvd, Salt Lake City, UT 84121-6894 | 2019-07-25 |
| 1841854338 | Tandy Muse | Family Medicine | 4460 S Highland Dr Ste 400, Salt Lake City, UT 84124-3565 | 2019-04-30 |
| 1821561408 | Terra Bowden | Family Medicine | 450 S 900 E Ste 175, Salt Lake City, UT 84102-2981 | 2019-01-07 |
| 1801379193 | Country Corner Family Medicine | Family Medicine | 5460 W Clernates Dr, Salt Lake City, UT 84118-8526 | 2018-09-12 |
| 1396259008 | Futura Medical Clinic | Family Medicine | 1407 W North Temple Ste 120, Salt Lake City, UT 84116-3187 | 2017-11-17 |
| 1427580174 | Lindsey Yanke | Family Medicine | 1365 South 1000 North, Salt Lake City, UT 84116-1654 | 2017-03-31 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84111 |
Please comment or provide details below to improve the information on FJM BASECAMP.
| 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.