Individual provider Active NPI

Joseph F Burum

  • Pharmacist
  • Roy, UT
National Provider Identifier
1164987137
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
323574-1701 Issued in UT
Practice address
4815 S 3500 W
Roy, UT 84067-9439
Phone
(801) 985-7011
NPI assigned
Feb 4, 2019
Last updated
Feb 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 323574-1701 UT Primary

Addresses

Primary practice location

4815 S 3500 W
Roy, UT 84067-9439

Mailing address

4815 S 3500 W
Roy, UT 84067-9439

Other identifiers 1

IdentifierTypeStateIssuer
1639649916MedicaidUT

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

State licenses

LicenseStateTypeSpecialty
323574-1701UTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Midland Pharmacy, LLC Current Accepting new patients

Locations

4815 S 3500 W
Roy, UT 84067
Phone (801) 985-7011

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1164987137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 S 3500 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 S 3500 W",
            "city": "ROY",
            "state": "UT",
            "postal_code": "840679439",
            "telephone_number": "801-985-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURUM",
        "first_name": "JOSEPH",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-04",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "323574-1701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639649916",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.