Physicians Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

2006-ASF-74408 Issued in UT

Legal business name

PHYSICIANS SURGERY CENTER, LLC

Practice address

1485 E 3900 S
Salt Lake City, UT 84124-1412

Phone

(801) 277-2062

Fax

(801) 274-3233

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Kevin H. Charlton, M.D.

Title

M.D. Manager - Member

Phone

(801) 277-2062

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Listed as

Physicians Surgery CenterCCN 46C0001044

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Kirk Edward Winward, MD

  • Retina Specialist (Ophthalmology) Physician
  • Salt Lake City, UT
  • NPI 1962487611
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1356395586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241412",
            "telephone_number": "801-277-2062",
            "fax_number": "801-274-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 E 3900 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241412",
            "telephone_number": "801-277-2062",
            "fax_number": "801-274-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2014-07-08",
        "status": "A",
        "authorized_official_last_name": "CHARLTON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "M.D. MANAGER - MEMBER",
        "authorized_official_telephone_number": "801-277-2062",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "UT",
            "license": "2006-ASF-74408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physician Specialty Care of Utah
• Physician Wound Care Specialists of Utah
• Physicians Laser Center
• Physicians Medical Group
• Physicians Service Group, Inc.
• Physiofit RX PLLC
• Lauren Elizabeth Piana, MD
• Dominique Piber, MD
• Allison Pickens
• Stephanie Korrina Pickering

• Ambulatory Surgical Clinic/Center in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Ambulatory Surgical Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.