OrganizationActive
Fjm Basecamp
NPI 1255858734 · Family Medicine Physician · Salt Lake City, UT
Provider details
- NPI number
- 1255858734
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Futura Medical Clinic
- Organization subpart
- Yes
- Authorized official
- Darce Latsis, Operations Manager(801) 441-1002
- License
- 70786441205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
185 S State St Ste 208
Salt Lake City, UT 84111-1558
Phone: (801) 821-5454
Fax: (801) 821-5455
Street-level locationGet directions
Mailing address
560 S 300 E Ste 275
Salt Lake City, UT 84111-3586
Other names (DBA / former)
- Doing business as
- Fjm Medical Clinic-Basecamp
Registry dates
- Enumerated
- 2017-08-25
- Last updated
- 2022-07-21
- Certified
- 2020-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.