Impact Medical LLC

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

Legal business name

IMPACT MEDICAL LLC

Practice address

1776 N Highway 40, Ste 101
Heber City, UT 84032

Phone

(435) 294-2664

Fax

(801) 274-0049

NPI assigned

Oct 7, 2025

Last updated

Oct 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Fogg, MDNPI 1104320902

Title

Physician

Phone

(801) 712-2535

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Reed Fogg, MD

  • Family Medicine Physician
  • Heber City, UT
  • NPI 1104320902
  Authorized official Same address or phone

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1487529764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 N HIGHWAY 40, STE 101",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "84032",
            "telephone_number": "435-294-2664",
            "fax_number": "801-274-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1776 N HIGHWAY 40, STE 101",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "84032",
            "telephone_number": "435-294-2664",
            "fax_number": "801-274-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "FOGG",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "801-712-2535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ihc Health Services Inc (Heber Valley Specialty Clinic)
• Ihc Health Services Inc (Intermountain Health Home Medical Equipment Heber City)
• Ihc Health Services Inc (Heber Valley Hospital Physicians)
• Ihc Health Services Inc (Heber Valley Medical Center)
• Ihc Health Services Inc (Heber Valley Dialysis)
• Chaoyu Irvin
• Autumn M Iverson
• Spencer Jacobson, DMD
• Jared R Brown DMD Ms PC (Wasatch Orthodontics and Dentofacial Orthopedics)
• Kelly B Jarvis Sr., D.C.

• Public Health & General Preventive Medicine Physician in Heber City, UT
• Providers in Heber City, UT by specialty
• Public Health & General Preventive Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.