Amp Utah Clinic P C

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

AMP UTAH CLINIC P C

Practice address

6686 S Highland Dr Ste 200
Cottonwood Heights, UT 84121-3037

Phone

(801) 937-9650

NPI assigned

May 15, 2023

Organization subpart

No

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

Authorized official

Name

Brian Reuben, MDNPI 1447457221

Title

Ceo

Phone

(801) 647-5522

Specialties & licenses 1

Addresses

Other names 1

• 22 Plastic Surgery, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

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

• Brian Christopher Reuben, M.D.

  • Surgery Physician
  • Cottonwood Heights, UT
  • NPI 1447457221

  UT

  Medicare reassignment Authorized official
• Neal Griffith Moores, M.D.

  • Plastic Surgery Physician
  • Murray, UT
  • NPI 1427374636

  UT

  Medicare reassignment

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1487345161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 MAPLE AVE STE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193936",
            "telephone_number": "801-937-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6686 S HIGHLAND DR STE 200",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841213037",
            "telephone_number": "801-937-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMP UTAH CLINIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-10-05",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "REUBEN",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-647-5522",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "22 Plastic Surgery, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "22 Plastic Surgery, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Allman
• Fatma Alper
• Lajae Shacole Alvarez
• Joselin Ambrocio
• American Care United,LLC
• Scott G Anders, MD
• Erica Patricia Anderson
• Icelle Marie Anderson
• Jessica Anderson
• Noah Anderson

• All providers in Cottonwood Heights, UT
• Plastic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.