Individual provider Active NPI

Walter D. Fife, M.D.

  • Independent Medical Examiner Physician
  • Bountiful, UT
National Provider Identifier
1376746651
Registry record updated Feb 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Medical Examiner PhysicianTaxonomy code 202C00000X
License
MD00013702 Issued in WA
Practice address
954 Barton CT
Bountiful, UT 84010-0906
Phone
(801) 683-8003
NPI assigned
Jun 6, 2007
Last updated
Feb 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner Physician 202C00000X MD00013702 WA Primary

Addresses

Primary practice location

954 Barton CT
Bountiful, UT 84010-0906

Mailing address

954 Barton CT
Bountiful, UT 84010-0906
Phone (801) 683-8003

Other identifiers 1

IdentifierTypeStateIssuer
1262807MedicaidWA

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 Medicine

State licenses

LicenseStateTypeSpecialty
MD00013702WAMDIndependent Medical Examiner Physician

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1376746651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 BARTON CT",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840100906",
            "telephone_number": "801-683-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 BARTON CT",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840100906",
            "telephone_number": "801-683-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIFE",
        "first_name": "WALTER",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202C00000X",
            "taxonomy_group": "",
            "desc": "Independent Medical Examiner",
            "state": "WA",
            "license": "MD00013702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1262807",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.