NPIMap

Organization Active NPI

Red Rocks Surgical Center PC

  • Ambulatory Surgical Clinic/Center
  • St George, UT
National Provider Identifier
1457076903
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
RED ROCKS SURGICAL CENTER PC
Practice address
624 S 1000 E Ste 105
St George, UT 84790-5902
Phone
(435) 274-7450
Fax
(435) 274-7455
NPI assigned
Oct 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Whitney Pavick
Title
Sr. Operations Manager
Phone
(435) 274-7450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

624 S 1000 E Ste 105
St George, UT 84790-5902

Mailing address

624 S 1000 E Ste 105
St George, UT 84790-5902
Phone (435) 274-7450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230619000667 UT Part B Supplier - Ambulatory Surgical Center 8022476308 Practice locations: St George, UT

Ambulatory surgical center certification: CCN 46C0001083

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Red Rocks Surgical Center PC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jan 4, 2024
Last certification
Jan 4, 2024
Ownership / control type
Proprietary
Facility address
624 South 1000 East
St George, UT 84790

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2283043Red Rocks Surgical Center PC624 S 1000 E Ste 105, St George, UT 84790Certificate of waiverMay 30, 2027

National Provider Directory

National Provider Directory

Locations

624 S 1000 E
Ste 105
St George, UT 84790
Phone (435) 274-7450

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1457076903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 S 1000 E STE 105",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847905902",
            "telephone_number": "435-274-7450",
            "fax_number": "435-274-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 S 1000 E STE 105",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847905902",
            "telephone_number": "435-274-7450",
            "fax_number": "435-274-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED ROCKS SURGICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-06",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "PAVICK",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_title_or_position": "SR. OPERATIONS MANAGER",
        "authorized_official_telephone_number": "435-274-7450"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.