Surgery Center Anesthesia, LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

199980-4406 Issued in UT

Legal business name

SURGERY CENTER ANESTHESIA, LLC

Practice address

5801 S Fashion Blvd
Suite 190
Murray, UT 84107-6159

Phone

(801) 983-6819

NPI assigned

Nov 21, 2016

Organization subpart

No

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

Authorized official

Name

Mark D Allen, MBA/MHS

Title

Owner

Phone

(801) 879-1048

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1245773399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 S FASHION BLVD",
            "address_2": "SUITE 190",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076159",
            "telephone_number": "801-983-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 S FASHION BLVD",
            "address_2": "SUITE 190",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076159",
            "telephone_number": "801-983-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-879-1048",
        "authorized_official_credential": "MBA/MHS"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "199980-4406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Murray, UT
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.