Wasatch Surgical LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

WASATCH SURGICAL LLC

Practice address

520 Medical Dr Ste 300
Bountiful, UT 84010-8925

Phone

(228) 273-9021

NPI assigned

Jul 7, 2025

Organization subpart

No

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

Authorized official

Name

Mackenzie Lee Goodwin, MDNPI 1942569231

Title

Owner

Phone

(228) 273-9021

Specialties & licenses 1

Addresses

Other names 1

• Mackenzie Goodwin MD Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mackenzie Lee Goodwin, M.D

  • Surgical Critical Care Physician
  • Bountiful, UT
  • NPI 1942569231

  Surgery

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1053201525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1893 E MILLBROOK RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841063827",
            "telephone_number": "228-273-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR STE 300",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108925",
            "telephone_number": "228-273-9021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74 Kimballs Lane",
            "address_2": "Bldg 2, Suite 260",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "84020",
            "country_code": "US",
            "telephone_number": "228-273-9021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WASATCH SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "MACKENZIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-273-9021",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mackenzie Goodwin MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clara Leah Warrick
• Wasatch Endodontics, PC
• Wasatch Foot and Ankle Specialists, LLC
• Wasatch Neurological Surgery PC
• Wasatch Rehab Inc
• Zetyra Washington
• John Orville Waterbury, LPC
• Courtney Waters
• Steven L Wayman, RPH,PHARMD
• Kristen Webb

• Surgery Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.