Spring Creek Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SPRING CREEK SURGICAL CENTER, LLC

Practice address

65 North Gateway Drive, Suite 3
Providence, UT 84332

Phone

(435) 213-6563

NPI assigned

Mar 24, 2015

Last updated

Mar 24, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stanton C. Allen, DDS

Title

Manager

Phone

(435) 213-6563

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Listed as

Spring Creek Surgical Center LLCCCN 46C0001061

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1033503420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 NORTH GATEWAY DRIVE, SUITE 3",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "84332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 NORTH GATEWAY DRIVE, SUITE 3",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "84332",
            "telephone_number": "435-213-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING CREEK SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "STANTON",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "435-213-6563",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Smith
• Katie Snow
• South Valley Eyecare Center, Inc.
• South Valley Pharmacy
• Spring Creek Dental Associates, LLC
• Springcreek Medical Center PC
• Jonathan Patrick Sprouse
• Seneca Stagg, RBT
• Sterling Recovery
• Richard T Stevens, MD

• Ambulatory Surgical Clinic/Center in Providence, UT
• Providers in Providence, UT by specialty
• Ambulatory Surgical Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.