PHYSICIANS SURGERY CENTER, LLC (NPI# 1356395586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356395586 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS SURGERY CENTER, LLC |
| Practice Address |
1485 E 3900 S Salt Lake City UT 84124-1412 |
| Practice Telephone | 8012772062 |
| Practice Fax Number | 8012743233 |
| Mailing Telephone | 8012772062 |
| Mailing Fax Number | 8012743233 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2014-07-08 |
| Authorized Official Name | KEVIN H. CHARLTON (M.D. MANAGER - MEMBER) |
| Authorized Official Telephone | 8012772062 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
2006-ASF-74408 | UT | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023297553 | Physicians Surgery Center, LLC | Clinic/Center | 2601 W Main St, Carbondale, IL 62901-1031 | 2007-11-01 |
| 1194729590 | Physicians Surgery Center, LLC | Clinic/Center | 1 Mercado St, Suite 210, Durango, CO 81301 | 2005-06-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | PHYSICIANS SURGERY CENTER, LLC | 9100 E. Mineral Circle, Centennial, CO 80112 |
| Street Address |
1485 E 3900 S |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84124-1412 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063790574 | Jeffrey Bell | Nurse Anesthetist, Certified Registered | 1485 E 3900 S, Salt Lake City, UT 84124-1438 | 2011-08-01 |
| 1457543258 | Alisia Kay Polzin | Technician/Technologist | 1485 E 3900 S, Salt Lake City, UT 84124-1438 | 2007-08-15 |
| 1184799173 | Mount Olympus Optical | Technician/Technologist | 1485 E 3900 S, Salt Lake City, UT 84124-1412 | 2006-11-22 |
| 1760492912 | Howard A Katzman | Ophthalmology | 1485 E 3900 S, Ste 104, Salt Lake City, UT 84124-1412 | 2006-08-09 |
| 1689693814 | Corey A Miller Md PC | Ophthalmology | 1485 E 3900 S, Ste 103, Salt Lake City, UT 84124-1412 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
| 1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
| 1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
| 1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
| 1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
| 1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
| 1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
| 1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
| 1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| Find all providers in zip 84124 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639704208 | Salt Lake Surgery Center, LLC | Clinic/Center | 1046 E 100 S Ste D, Salt Lake City, UT 84102-1520 | 2020-03-04 |
| 1952720674 | Bountiful Surgery Center, LLC | Clinic/Center | 6360 S 3000 E Ste 320, Salt Lake City, UT 84121-6932 | 2014-04-09 |
| 1932407277 | Stephen H Bennett Md PC | Clinic/Center | 1045 E 3900 S Ste 201, Salt Lake City, UT 84124-1192 | 2011-03-10 |
| 1568644771 | Physicians Service Group, Inc. | Clinic/Center | 7369 East 2223 South, Salt Lake City, UT 84109 | 2007-11-29 |
| 1780885442 | Lyssa Inc | Clinic/Center | 530 E 500 S, Salt Lake City, UT 84102-2746 | 2007-05-30 |
| 1790906204 | Ear, Nose & Throat Surgery Center of Utah LLC | Clinic/Center | 22 S 900 E Ste 2, Salt Lake City, UT 84102-1307 | 2007-05-01 |
| 1164647707 | Ihc Health Services, Inc. | Clinic/Center | 359 8th Ave, Salt Lake City, UT 84103-2895 | 2007-04-17 |
| 1922148063 | The Surgery Center At Salt Lake Regional, L.L.C. | Clinic/Center | 82 South 1100 East, Suite 200, Salt Lake City, UT 84102 | 2007-02-07 |
| 1881701290 | Wasatch Endoscopy Center Ltd | Clinic/Center | 1220 E 3900 S Ste 1b, Salt Lake City, UT 84124-1327 | 2006-08-23 |
| 1609896216 | Salt Lake Endoscopy Center | Clinic/Center | 24 S 1100 E Ste 103, Salt Lake City, UT 84102-1592 | 2006-07-20 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.