Surgery Center at South Ogden, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SURGERY CENTER AT SOUTH OGDEN, LLC

Practice address

955 Chambers St Ste 101
South Ogden, UT 84403-4877

Phone

(801) 317-4896

NPI assigned

Nov 30, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Geoffrey Burgess

Title

Board Member

Phone

(801) 317-4896

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Listed as

Surgery Center at South Ogden LLCCCN 46C0001070

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": "1606694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606694400000",
    "number": "1033714001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 CHAMBERS ST STE 101",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034877",
            "telephone_number": "801-317-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 CHAMBERS ST STE 101",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034877",
            "telephone_number": "801-317-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER AT SOUTH OGDEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-30",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "801-317-4896",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia L. Steward, RN
• Kirsten Straniere, CCC-SLP
• Structura Body Therapies, LLC
• Amy Sudbury
• Superior Smiles Incorporated
• T Sharman Sutherland, M.D.
• Jesse Scott Swift, M.D.
• Mohammad Omer Syed, MD
• Kathryn Szanter
• Patrick McNeil Tanner, DMD

• Ambulatory Surgical Clinic/Center in South Ogden, UT
• Providers in South Ogden, 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 Nov 30, 2020; 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.