Brian W Fukushima MD PC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

5280409-1205 Issued in UT

Legal business name

BRIAN W FUKUSHIMA MD PC

Practice address

5323 South Woodrow Street
Suite 200
Murray, UT 84107

Phone

(801) 747-1020

Fax

(801) 747-1023

NPI assigned

Dec 19, 2007

Organization subpart

No

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

Authorized official

Name

Katie Benard

Title

Office Manager

Phone

(801) 747-1020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

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

• Brian W Fukushima, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Murray, UT
  • NPI 1073543740
  Medicare reassignment NPD

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1295919728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5323 SOUTH WOODROW STREET",
            "address_2": "SUITE 200",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-747-1020",
            "fax_number": "801-747-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 SOUTH WOODROW STREET",
            "address_2": "SUITE 200",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-747-1020",
            "fax_number": "801-747-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN W FUKUSHIMA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "BENARD",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-747-1020"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "UT",
            "license": "5280409-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron L Bress, DO
• Amanda Best Breviu, M.D.
• Brian Andrew Breviu, M.D.
• Wendy A Breyer, MD
• Brian J. Rodriguez, PT, PC
• Robert Brickley
• Cory Ray Briggle, OTR/L
• Donald Roy Briggs, LPC
• Brightenlife Home Health LLC
• Brighton Medical Group

• Sports Medicine (Orthopaedic Surgery) Physician in Murray, UT
• Providers in Murray, UT by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.