NPIMap

Organization Active NPI

Huntsman West Spine LLC

  • Orthopaedic Surgery of the Spine Physician
  • Saint George, UT
National Provider Identifier
1457793697
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
8635840-1205 Issued in UT
Legal business name
HUNTSMAN WEST SPINE LLC
Practice address
230 N 1680 E
Ste I-1
Saint George, UT 84790-2579
Phone
(435) 652-6024
Fax
(435) 652-6025
NPI assigned
Jul 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Authorized official

Name
Kristoffer R West, MDNPI 1285898650
Title
Member / Manager
Phone
(435) 652-6024

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X 8635840-1205 UT Primary

Addresses

Primary practice location

230 N 1680 E
Ste I-1
Saint George, UT 84790-2579

Mailing address

617 E Riverside Dr Ste 302
St George, UT 84790-8722
Phone (435) 652-6024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131118001720 UT Part B Supplier - Clinic/Group Practice 0345476560 Receives reassigned benefits from 9 practitioners
Practice locations: Cedar City, UT; St George, UT
O20161118000512 UT DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0345476560 Practice locations: St George, UT

National Provider Directory

National Provider Directory

Locations

2311 N Main St
Cedar City, UT 84721
Phone (435) 652-6024

617 E Riverside Dr
Ste 302
St George, UT 84790
Phone (435) 652-6024

2891 E Mall Dr
Ste 105
St George, UT 84790

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1457793697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 E RIVERSIDE DR STE 302",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908722",
            "telephone_number": "435-652-6024",
            "fax_number": "435-652-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N 1680 E",
            "address_2": "STE I-1",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847902579",
            "telephone_number": "435-652-6024",
            "fax_number": "435-652-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTSMAN WEST SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-29",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "KRISTOFFER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER / MANAGER",
        "authorized_official_telephone_number": "435-652-6024",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "UT",
            "license": "8635840-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.