NPIMap

Organization Active NPI

Independence Physician and Resource

  • General Practice Physician
  • Bountiful, UT
National Provider Identifier
1851785919
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
INDEPENDENCE PHYSICIAN AND RESOURCE
Practice address
640 S 500 W
Bountiful, UT 84010-7210
Phone
(801) 298-1100
Fax
(801) 298-1988
NPI assigned
Mar 26, 2015
Last updated
Apr 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Authorized official

Name
Daniel Frasure
Title
Managing Partner
Phone
(801) 698-8927

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

640 S 500 W
Bountiful, UT 84010-7210

Mailing address

640 S 500 W
Bountiful, UT 84010-7210
Phone (801) 298-1100

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1851785919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S 500 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107210",
            "telephone_number": "801-298-1100",
            "fax_number": "801-298-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S 500 W",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107210",
            "telephone_number": "801-298-1100",
            "fax_number": "801-298-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE PHYSICIAN AND RESOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-26",
        "last_updated": "2015-04-03",
        "status": "A",
        "authorized_official_last_name": "FRASURE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "801-698-8927"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 3, 2015; 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.