Individual provider Active NPI

David Pullen Fisher, PHARM D

  • Pharmacist
  • South Jordan, UT
National Provider Identifier
1134729619
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
153401-1701 Issued in UT
Practice address
11328 S Jordan Gtwy
South Jordan, UT 84095-4112
Phone
(801) 553-2270
Fax
(801) 553-9141
NPI assigned
Oct 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 153401-1701 UT Primary

Addresses

Primary practice location

11328 S Jordan Gtwy
South Jordan, UT 84095-4112

Mailing address

11328 S Jordan Gtwy
South Jordan, UT 84095-4112
Phone (801) 553-2270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
153401-1701UTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1134729619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11328 S JORDAN GTWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954112",
            "telephone_number": "801-553-2270",
            "fax_number": "801-553-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11328 S JORDAN GTWY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954112",
            "telephone_number": "801-553-2270",
            "fax_number": "801-553-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "DAVID",
        "middle_name": "PULLEN",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "153401-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.