Alta Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ALTA SURGERY CENTER

Practice address

6322 S 3000 E Ste 170
Salt Lake City, UT 84121-7290

Phone

(801) 513-3223

NPI assigned

Sep 29, 2026

Last updated

Sep 29, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Poulsen

Title

Managing Member

Phone

(559) 313-6472

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1790640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1487568382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6322 S 3000 E STE 170",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841217290",
            "telephone_number": "801-513-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6322 S 3000 E STE 170",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841217290",
            "telephone_number": "801-513-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-29",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "POULSEN",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "559-313-6472",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muatassem A. Alsadhan, MBBS
• Briggs Alsbury
• Maha Ismail a Alsomali, MD
• Emily Alston, MSN, APRN, FNP-C
• Alta Bella Plastic Surgery PLLC
• Kate Alta, DO
• Francisco Altamirano Lamarque, MD
• Rayyan Fahad H Altemani, MBBS
• Clara Lynn Altemus, OTR
• David L. Altman, D.C.

• 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 Sep 29, 2026; 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.