Stephanie Boulter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

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

Phone

(801) 917-5561

Fax

(800) 775-1064

NPI assigned

Dec 16, 2008

Last updated

Aug 12, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: surgicalsynergy.stephanieboulter@134582.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Surgical Synergy, LLC

  dba Happiness Effect

  • Physician Assistant
  • Cottonwood Heights, UT
  • NPI 1124489968
  Medicare reassignment Authorized official
• Ryan K Anderson D P M P C

  dba Foot & Ankle Specialists of Utah

  • Foot & Ankle Surgery Podiatrist
  • Bountiful, UT
  • NPI 1639200215
  NPD (past)

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1295970515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8132 S 3500 E",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841215956",
            "telephone_number": "801-995-1235",
            "fax_number": "800-775-1064"
        },
        {
            "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": "800-775-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULTER",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-16",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Elise Bohn
• Melissa A Boll, CNM
• Nicholas Bolton, LCSW
• Carl Bombardier, RDN
• Suresh Boodram, RPH
• Michael Spenser Bowen, DDS
• Lennea R Bower
• Lori Bowser, APRN
• Lincoln Bradshaw
• Chloe Caitlyn Bramwell

• 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 Aug 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.