Bountiful Surgical Associates

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

BOUNTIFUL SURGICAL ASSOCIATES

Practice address

425 Medical Drive #101
Bountiful, UT 84010

Phone

(801) 298-1123

Fax

(801) 292-1271

NPI assigned

Mar 4, 2008

Last updated

Mar 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Russell H Todd, MD

Title

President

Phone

(801) 298-1123

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin N Clark, MD

  • Surgery Physician
  • Bountiful, UT
  • NPI 1235127291
  NPD (past)
• Jon C Oberg, M.D.

  • Surgery Physician
  • Bountiful, UT
  • NPI 1316035942
  NPD (past)

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1316117567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MEDICAL DRIVE #101",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "84010",
            "telephone_number": "801-298-1123",
            "fax_number": "801-292-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MEDICAL DRIVE #101",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "84010",
            "telephone_number": "801-298-1123",
            "fax_number": "801-292-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNTIFUL SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "TODD",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-298-1123",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bountiful Pediatrics and Neonatology Inc
• Bountiful Radiology Associates Inc
• Bountiful Ridge Anesthesia, PLLC
• Bountiful Ridge Dental, LLC
• Bountiful Surgery Center LLC
• Bountiful Vision Plaza PC
• Kelly Bowen, LCSW
• Maeve Bowen
• Ashlyn Bowles
• Becky Bowman, CSW

• Surgery Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.