Surgical Synergy, LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

SURGICAL SYNERGY, LLC

Practice address

1265 E Fort Union Blvd Ste 120
Cottonwood Heights, UT 84047-1845

Phone

(801) 917-5561

Fax

(801) 572-9992

NPI assigned

Mar 7, 2016

Organization subpart

Yes

Parent organization

SURGICAL SYNERGY, LLCAs reported in NPPES

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

Authorized official

Name

Stephanie Boulter, PA-CNPI 1295970515

Title

Manager

Phone

(801) 995-1235

Specialties & licenses 1

Addresses

Other names 1

• Happiness Effect Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Part of

Surgical Synergy LLC

Practitioners 1

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

• Stephanie Boulter, PA-C

  • Physician Assistant
  • Cottonwood Heights, UT
  • NPI 1295970515
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1124489968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 E FORT UNION BLVD STE 120",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "840471845",
            "telephone_number": "801-917-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 E FORT UNION BLVD STE 120",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "840471845",
            "telephone_number": "801-917-5561",
            "fax_number": "801-572-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL SYNERGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SURGICAL SYNERGY, LLC",
        "enumeration_date": "2016-03-07",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "BOULTER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-995-1235",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Happiness Effect",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stone Mountain Surgical, LLC
• Jennifer Jill Stone, APRN PMHNP
• Megan Sturdevant, MA, ACMHC
• William Patrick Sullenger
• Ella Suprise
• Jackqueline Noel Tabara, BCBA
• Ashlee Talbot
• Kaycee R Tanner
• Kelsey Tanner
• Josephine Sheila Tate

• Physician Assistant in Cottonwood Heights, UT
• Providers in Cottonwood Heights, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.