Grant a. Fairbanks, MD PC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

2744901205 Issued in UT

Legal business name

GRANT A. FAIRBANKS, MD PC

Practice address

520 Medical Dr
Suite 210
Bountiful, UT 84010-4968

Phone

(801) 268-8838

NPI assigned

Jul 20, 2010

Organization subpart

No

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

Authorized official

Name

Grant A Fairbanks

Title

Provider

Phone

(801) 701-8688

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Grant R Fairbanks, MD

  • Plastic Surgery Physician
  • Salt Lake City, UT
  • NPI 1861531105
  NPD (past)

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447977600000",
    "number": "1891008777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1071",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840111071",
            "telephone_number": "801-701-8688",
            "fax_number": "801-701-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR",
            "address_2": "SUITE 210",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104968",
            "telephone_number": "801-268-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT A. FAIRBANKS, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-20",
        "last_updated": "2015-11-20",
        "status": "A",
        "authorized_official_last_name": "FAIRBANKS",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "801-701-8688"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "UT",
            "license": "2744901205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anu Goyal, M.S.W., BCBA
• Kylie Graham
• Grandview Healthcare LLC (Symbii Davis Home Health)
• Grandview Healthcare LLC (Symbii Davis Hospice)
• Esther Juliene Grandy, TRS, CTRS
• Grant L Christian MD a Professional Corporation
• Brittney Jess Grant-Reynolds
• Madison Grant
• Abigail Lauren Gray
• Brianna Green, CMHC, MT-BC

• Plastic Surgery Physician in Bountiful, UT
• Providers in Bountiful, 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 Nov 20, 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.