FJM MEDICAL CLINIC-BASECAMP
NPI 1255858734
Family Medicine in Salt Lake City, UT

Q: What is Fjm Basecamp's NPI number?

The NPI number for Fjm Basecamp is 1255858734. It was assigned to this organization in the NPPES registry on August 25, 2017. The provider is doing business as Fjm Medical Clinic-Basecamp.

Q: What is Fjm Basecamp's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Fjm Basecamp was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 25, 2017CLIA 46D2136657 · Microscopy

185 S STATE ST STE 208, SALT LAKE CITY, UT 84111(801) 821-5454(801) 821-5455 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jan 30, 2020, Aug 25, 2017 (3 updates tracked since 2017).

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About Fjm Medical Clinic-basecamp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FJM MEDICAL CLINIC-BASECAMP (NPI 1255858734) is a healthcare organization registered as a family medicine in Salt Lake City, Utah and active in the NPI registry since August 2017. The organization holds a CLIA Microscopy certificate valid through April 22, 2028 and lists Darce A Latsis, Operations Manager, as its authorized official.

NPPES Registry Identity

NPI1255858734

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameFJM BASECAMP

Location Address185 S STATE ST STE 208Salt Lake City, UT 84111-1558

Mailing Address560 S 300 E Ste 275Salt Lake City, UT 84111-3586 · (801) 441-1002

Phone(801) 821-5454

Fax(801) 821-5455

Organization SubpartYesParent: Futura Medical Clinic

Authorized OfficialDarce A LatsisOperations Manager · (801) 441-1002

Enumeration DateAugust 25, 2017

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

NPPES CertifiedJanuary 30, 2020

✔ NPI 1255858734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in UT · 70786441205

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

185 S STATE ST STE 208, Salt Lake City, UT 84111

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Other Names 1

Doing Business AsFjm Medical Clinic-basecamp

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 46D2136657

Fjm Medical Clinic Basecamp · Salt Lake City, UT

Active · expires Apr 22, 2028

CLIA Number46D2136657

Laboratory TypePhysician Office

Certificate Effective DateApril 23, 2026

Certificate Expiration DateApril 22, 2028

Laboratory DirectorTimothy Young

Laboratory Phone(801) 821-5454

Laboratory LocationFjm Medical Clinic Basecamp185 S State Street, Suite 208, Salt Lake City, UT 84111

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fjm Basecamp's NPI number?

The NPI number for Fjm Basecamp is 1255858734. It was assigned to this organization in the NPPES registry on August 25, 2017. The provider is doing business as Fjm Medical Clinic-Basecamp.

Where is Fjm Basecamp located?

Fjm Basecamp is located at 185 S State St Ste 208, Salt Lake City, UT 84111. The listed phone number is (801) 821-5454.

What is Fjm Basecamp's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Fjm Basecamp hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 46D2136657) is associated with this NPI, valid through April 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fjm Basecamp was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.