NPIMap

Organization Active NPI

Center for Advanced Plastic Surgery

  • Specialist
  • St George, UT
National Provider Identifier
1316998560
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
345016 Issued in UT
Legal business name
CENTER FOR ADVANCED PLASTIC SURGERY
Practice address
676 S Bluff St
Suite 207
St George, UT 84770-3596
Phone
(435) 628-2895
Fax
(435) 628-5943
NPI assigned
May 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Marcus L Peterson, MD FACSNPI 1518918713
Title
Partner
Phone
(435) 628-2895

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 345016 UT Primary

Addresses

Primary practice location

676 S Bluff St
Suite 207
St George, UT 84770-3596

Mailing address

676 S Bluff St
Suite 207
St George, UT 84770-3596
Phone (435) 628-2895

Other identifiers 8

IdentifierTypeStateIssuer
19344612000001OtherUTREGENCE
902568OtherUTDMBA
0007137728OtherUTAETNA
101009187101OtherUTIHC RHODES
2085401OtherNVBCBS NV
107007770102OtherUTIHC PET
0004328723OtherKYAETNA
19344612000001OtherUTVALUECARE

National Provider Directory

National Provider Directory

Locations

676 S Bluff St
Ste 207
St George, UT 84770
Phone (435) 628-2895

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316998560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 S BLUFF ST",
            "address_2": "SUITE 207",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703596",
            "telephone_number": "435-628-2895",
            "fax_number": "435-628-5943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 S BLUFF ST",
            "address_2": "SUITE 207",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847703596",
            "telephone_number": "435-628-2895",
            "fax_number": "435-628-5943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ADVANCED PLASTIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "435-628-2895",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD FACS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "345016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "19344612000001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "902568",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007137728",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC RHODES",
            "identifier": "101009187101",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NV",
            "identifier": "2085401",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IHC PET",
            "identifier": "107007770102",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004328723",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUECARE",
            "identifier": "19344612000001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.