NPIMap

Organization Active NPI

Foundation Medical LLC

  • Psychiatry Physician
  • American Fork, UT
National Provider Identifier
1104760685
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FOUNDATION MEDICAL LLC
Practice address
456 E State Rd Ste 1400
American Fork, UT 84003-2609
Phone
(804) 506-0526
NPI assigned
Apr 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy James Bunton
Title
Ceo
Phone
(804) 506-0526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

456 E State Rd Ste 1400
American Fork, UT 84003-2609

Mailing address

11600 Busy Street
Ste 203
Richmond, VA 23236-4066
Phone (804) 506-0526

Other names 1

  • Foundation Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Foundation Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

456 E State Rd
Ste 1400
American Fork, UT 84003
Phone (804) 506-0526

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1776297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776297600000",
    "number": "1104760685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 BUSY STREET",
            "address_2": "STE 203",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232364066",
            "telephone_number": "804-506-0526",
            "fax_number": "804-506-0526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 E STATE RD STE 1400",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032609",
            "telephone_number": "804-506-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-16",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A",
        "authorized_official_last_name": "BUNTON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-506-0526"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foundation Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in American Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.