Grant R Fairbanks, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

1487731205 Issued in UT

Practice address

1151 E 3900 S
Suite B110
Salt Lake City, UT 84124-1216

Phone

(801) 268-8838

Fax

(801) 268-8264

NPI assigned

Feb 5, 2007

Last updated

Jan 4, 2013By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Grant R Fairbanks MD PC

  • Plastic Surgery Physician
  • Salt Lake City, UT
  • NPI 1578699039
  NPD (past) Authorized official
• Grant a. Fairbanks, MD PC

  • Plastic Surgery Physician
  • Bountiful, UT
  • NPI 1891008777
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1861531105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 E 3900 S",
            "address_2": "SUITE B110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241216",
            "telephone_number": "801-268-8838",
            "fax_number": "801-268-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 E 3900 S",
            "address_2": "SUITE B110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241216",
            "telephone_number": "801-268-8838",
            "fax_number": "801-268-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "GRANT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "UT",
            "license": "1487731205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlyn Fahrenkamp
• Scott L Fahrner, MD
• Jared Faigle
• Jennica Lynne Failner
• Philip Fair
• Rebecca Christensen Fairbanks, LCSW
• Spencer Fairbanks
• Brayden Fairbourn
• Fairbourne Group
• Kyle Fairchild, MS OTR/L

• Plastic Surgery Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Plastic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.