Organization Active NPI

Murray Surgical

  • Ambulatory Surgical Clinic/Center
  • Murray, UT
National Provider Identifier
1255680559
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MURRAY SURGICAL
Practice address
5801 S Fashion Blvd
#190
Murray, UT 84107-6159
Phone
(801) 879-1048
NPI assigned
Aug 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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

Authorized official

Name
Mr. Mark Allen
Title
Principle
Phone
(801) 879-1048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

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

Mailing address

PO Box 900421
Sandy, UT 84090-0421
Phone (801) 879-1048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121023000479 UT Part B Supplier - Ambulatory Surgical Center 6002066321 Practice locations: Murray, UT

Ambulatory surgical center certification: CCN 46C0001057

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
MURRAY SURGICAL
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jul 21, 2014
Last certification
Jul 21, 2014
Ownership / control type
Proprietary
Facility address
5801 South Fashion Blvd, Suite 190
Murray, UT 84107

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2061719Murray Surgical5801 South Fashion Blvd #190, Murray, UT 84107Certificate of waiverJul 1, 2027

National Provider Directory

National Provider Directory

Locations

5801 S Fashion Blvd
Ste 190
South Salt Lake, UT 84107
Phone (801) 314-4736

NPI Registry JSON

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420156800000",
    "number": "1255680559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 900421",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840900421",
            "telephone_number": "801-879-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 S FASHION BLVD",
            "address_2": "#190",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841076159",
            "telephone_number": "801-879-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MURRAY SURGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-31",
        "last_updated": "2015-01-02",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRINCIPLE",
        "authorized_official_telephone_number": "801-879-1048",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.