Mountainwest Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

2006-31532 Issued in UT

Legal business name

MOUNTAINWEST SURGICAL CENTER LLC

Practice address

1551 S Renaissance Towne Dr
Suite 200
Bountiful, UT 84010-7667

Phone

(801) 383-1111

Fax

(801) 383-1115

NPI assigned

May 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Brian Berg

Title

Administrator

Phone

(801) 383-1111

Specialties & licenses 1

Addresses

Other identifiers 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

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256688000000",
    "number": "1124079843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR STE 200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107668",
            "telephone_number": "801-383-1111",
            "fax_number": "801-383-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 S RENAISSANCE TOWNE DR",
            "address_2": "SUITE 200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107667",
            "telephone_number": "801-383-1111",
            "fax_number": "801-383-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINWEST SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-383-1111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "UT",
            "license": "2006-31532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870630186001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mountain West Medicine, Inc.
• Mountain West Surgery Center, LLC
• Mountainstar Behavioral Health LLC
• Mountainstar Behavioral Health LLC
• Mountaintop Audiology LLC
• Mt Ogden Eye Center LLC
• Dawn Muhlestein, PA-C
• Jessee Muhlestein
• Nadia Mulder
• Simren Multani

• Ambulatory Surgical Clinic/Center in Bountiful, UT
• Providers in Bountiful, 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 Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.