J David Bane, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

1549951205 Issued in UT

Practice address

3725 W 4100 South
West Valley City, UT 84120

Phone

(801) 965-3600

Fax

(801) 965-3526

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1477584837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 W 4100 SOUTH",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "84120",
            "telephone_number": "801-965-3600",
            "fax_number": "801-965-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 W 4100 SOUTH",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "84120",
            "telephone_number": "801-965-3600",
            "fax_number": "801-965-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANE",
        "first_name": "J",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "1549951205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brynn Rebecca Bailey
• Jeremy Bailey, LMFT
• Brent L Baker
• William J Baker
• Laura Ballesteros
• Creston P Bangerter
• Samuel Barco, DNP
• Nolan D Barnett, PHARMD
• Kira Sunshine Barondeau, PA-C
• Rebecca B Barrett, SSW

• All providers in West Valley City, UT
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.