Southern Utah Surgical and Laser Aesthetics LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHERN UTAH SURGICAL AND LASER AESTHETICS LLC

Doing business as

Riverside Medical Arts

Practice address

1068 E Riverside Dr
St George, UT 84790-4477

Phone

(435) 628-6466

Fax

(435) 628-3845

NPI assigned

Jan 9, 2009

Organization subpart

No

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

Authorized official

Name

Benjamin Carter, M.D.NPI 1093919912

Title

Owner

Phone

(435) 628-6466

Specialties & licenses 2

Addresses

Other names 1

• Riverside Medical Arts Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Gill Carter, M.D.

  • Dermatology Physician
  • St George, UT
  • NPI 1093919912
  Medicare reassignment Care Compare group Authorized official
• Cameron J Hunter, PA-C

  • Physician Assistant
  • St George, UT
  • NPI 1619418472
  Medicare reassignment Care Compare group
• Hannah Weaver, PA

  • Physician Assistant
  • St George, UT
  • NPI 1376126995
  Medicare reassignment Care Compare group
• April Alexander Larson, M.D.

  • Dermatology Physician
  • St George, UT
  • NPI 1659446946
  Medicare reassignment NPD
• Julie Darrington

  • Family Nurse Practitioner
  • St George, UT
  • NPI 1699505925
  NPD
• Carolyn Hansen, FNP-BC

  • Nurse Practitioner
  • St George, UT
  • NPI 1497213425
  NPD (past)

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1114164365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 E RIVERSIDE DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904477",
            "telephone_number": "435-628-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 E RIVERSIDE DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904477",
            "telephone_number": "435-628-6466",
            "fax_number": "435-628-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN UTAH SURGICAL AND LASER AESTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-09",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-628-6466",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Medical Arts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern Utah Hyperbarics LLC
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• Southern Utah Neuropsychiatry
• Southern Utah Physical Therapy, LLC
• Southern Utah Primary and Urgent Care
• Southern Utah Surgical Arts
• Southern Utah Surgical Arts (Oral & Facial Surgery Institute)
• Southwest Behavioral Health Center
• Southwest Behavioral Health Center
• Southwest Center (Southwest Behavioral Health Center)

• Specialist in St George, UT
• Providers in St George, UT by specialty
• Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.