Willow Bend Surgical Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

WILLOW BEND SURGICAL CENTER

Practice address

650 E 4500 S Ste 100
Salt Lake City, UT 84107-4536

Phone

(801) 450-6940

Fax

(801) 944-5910

NPI assigned

May 18, 2021

Organization subpart

No

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

Authorized official

Name

Matthew Paul Wood, DC

Title

President

Phone

(801) 450-6940

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1043884604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 E INDIAN WELLS LN",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208301",
            "telephone_number": "801-450-6940",
            "fax_number": "801-944-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E 4500 S STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841074536",
            "telephone_number": "801-450-6940",
            "fax_number": "801-944-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW BEND SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-450-6940",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Willis, MS, ATC-L, CES
• Jamie Silver Willmott, MS, CGC
• Sigal A. Willner, MD
• Barbara Ann Willobee, CMHC
• Laurel A Willoughby
• Willow Creek Health Care
• Jason C Wills, M.D.
• Sarah Beth Wills, PA-C
• Sheila Willson
• Alex Wilner

• Ambulatory Surgical Clinic/Center in Salt Lake City, UT
• Providers in Salt Lake City, 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 May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.