Mountainstar Specialty Services LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MOUNTAINSTAR SPECIALTY SERVICES LLC

Practice address

1250 E 3900 S
Ste 460
Salt Lake City, UT 84124-1348

Phone

(801) 262-3564

Fax

(801) 262-3613

NPI assigned

Jun 25, 2007

Organization subpart

No

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

Authorized official

Name

Louis Joseph

Title

VP

Phone

(615) 373-7630

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 36

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

• Spencer Hayden Amundsen, M.D.

  • Orthopaedic Surgery Physician
  • Draper, UT
  • NPI 1841517257

  UT

  Medicare reassignment Care Compare group NPD
• Justin D Atherton, DO

  • Surgery Physician
  • Draper, UT
  • NPI 1386876167

  Surgery, UT

  Medicare reassignment Care Compare group NPD
• Mikayla Boggs, FNP-C

  • Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1578447520

  UT

  Medicare reassignment Care Compare group NPD
• Robert B Bourne, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Salt Lake City, UT
  • NPI 1487646998

  UT

  Medicare reassignment Care Compare group NPD
• James Earl Brewster, DO

  • Orthopaedic Surgery Physician
  • Draper, UT
  • NPI 1407248990

  UT

  Medicare reassignment Care Compare group NPD
• Angelo Gregory Chachas, MD

  • Surgery Physician
  • Salt Lake City, UT
  • NPI 1194726232

  Surgery, UT

  Medicare reassignment Care Compare group NPD
• Enrique Feria-Arias, M.D.

  • Orthopaedic Surgery Physician
  • Salt Lake City, UT
  • NPI 1033473574

  Single Specialty, UT

  Medicare reassignment Care Compare group NPD
• David Holt, MD

  • Orthopaedic Hand Surgery Physician
  • Salt Lake City, UT
  • NPI 1669616249

  UT

  Medicare reassignment Care Compare group NPD
• Jeffrey D Jackson, MD

  • Orthopaedic Surgery Physician
  • Salt Lake City, UT
  • NPI 1033123179

  UT

  Medicare reassignment Care Compare group NPD
• Richard Brian Mackey, MD

  • Orthopaedic Surgery Physician
  • Draper, UT
  • NPI 1992923874

  UT

  Medicare reassignment Care Compare group NPD
• Stuart C Marshall Jr., MD

  • Orthopaedic Surgery Physician
  • Draper, UT
  • NPI 1447204821

  UT

  Medicare reassignment Care Compare group NPD
• Andrea Jensen Matich, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Draper, UT
  • NPI 1902092133

  UT

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693267200000",
    "number": "1265638357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274525",
            "telephone_number": "615-373-7406",
            "fax_number": "866-346-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S",
            "address_2": "STE 460",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241348",
            "telephone_number": "801-262-3564",
            "fax_number": "801-262-3613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINSTAR SPECIALTY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "615-373-7630"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265638357",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa M Mountain, PH.D.
• Mountainstar Cardiology St Marks LLC
• Mountainstar Cardiovascular Services LLC
• Mountainstar Medical Group Neurosurgery - St Marks LLC
• Mountainstar Medical Group-St. Marks Hospital, LLC
• Shanalee E. Mountan, MD
• Allison Renee Mounts
• Claudia Mousques
• Elizabeth Grace Mouw, DO
• Move Well Age Well, LLC

• All providers in Salt Lake City, UT
• Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; 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.