NPIMap

Organization Active NPI

Premier Plastic Surgery Group of Utah, L.L.C.

  • Specialist
  • Sandy, UT
National Provider Identifier
1497941603
Registry record updated Jan 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PREMIER PLASTIC SURGERY GROUP OF UTAH, L.L.C.
Practice address
9829 S 1300 E
200
Sandy, UT 84094-4000
Phone
(801) 571-2020
Fax
(801) 571-6899
NPI assigned
Sep 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2008

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

Authorized official

Name
Steven H Warnock, M.D.NPI 1457337594
Title
Partner
Phone
(801) 571-2020

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

9829 S 1300 E
200
Sandy, UT 84094-4000

Mailing address

9829 S 1300 E
200
Sandy, UT 84094-4000
Phone (801) 571-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040910000970 UT Part B Supplier - Clinic/Group Practice 6406823392 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
Practice locations: Bountiful, UT; Draper, UT; Salt Lake City, UT; Sandy, UT

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Premier Plastic Surgery Group of Utah2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1220 E 3900 S
Ste 4I
Salt Lake Cty, UT 84124
Phone (801) 263-1621

9829 S 1300 E
Ste 200
Sandy, UT 84094
Phone (801) 571-2020

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1497941603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9829 S 1300 E",
            "address_2": "200",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944000",
            "telephone_number": "801-571-2020",
            "fax_number": "801-571-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9829 S 1300 E",
            "address_2": "200",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840944000",
            "telephone_number": "801-571-2020",
            "fax_number": "801-571-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PLASTIC SURGERY GROUP OF UTAH, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "WARNOCK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "801-571-2020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; 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.