Mark E Fruin, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

1809551205 Issued in UT

Practice address

5444 S. Green St.
Murray, UT 84123-5632

Phone

(801) 262-8120

Fax

(801) 262-3897

NPI assigned

Nov 7, 2005

Last updated

Aug 30, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 7

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Utah Radiology, PC

  • Diagnostic Radiology Physician
  • Nephi, UT
  • NPI 1548261290
  NPD (past)
• MMPS Murray

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1427005586
  NPD (past)
• Schryver Medical Sales and Marketing LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Sandy, UT
  • NPI 1528006046
  NPD (past)
• Utah Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Farmington, UT
  • NPI 1629076229
  NPD (past)
• Utah Imaging Centers LLC

  • Magnetic Resonance Imaging Radiologic Technologist
  • West Valley City, UT
  • NPI 1598763294
  NPD (past)
• West Valley Imaging LLC

  dba Utah Imaging West Valley

  • Diagnostic Radiology Physician
  • West Valley City, UT
  • NPI 1013231612
  NPD (past)
• New Schryver LLC

  dba TridentCare

  • Clinical Medical Laboratory
  • Carrollton, TX
  • NPI 1689025116
  NPD (past)

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1578544797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5444 S. GREEN ST.",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-8120",
            "fax_number": "801-262-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5444 S. GREEN ST.",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841235632",
            "telephone_number": "801-262-8120",
            "fax_number": "801-262-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUIN",
        "first_name": "MARK",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "UT",
            "license": "180955-1205",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "UT",
            "license": "1809551205",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M-11498",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00255592",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00205749",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003698900",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004820",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09768",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120731800",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002089673",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Frischknecht, ACNP
• Christian D Froerer, M.D.
• Frontier Leasing Management LC (Love Home Health)
• Andrew Bradley Frost, DPT
• Scott Paul Frost, MPT
• Justin Craig Fry, OTR/L
• Yvonne Potter Fuellenbach, PA-C
• Juan D Fuentes, M.D.
• Cami Fuhriman, CSW
• Shiro Fujita, MD

• Diagnostic Radiology Physician in Murray, UT
• Providers in Murray, UT by specialty
• Diagnostic Radiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.