Wise Cleft Center for Excellence LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

WISE CLEFT CENTER FOR EXCELLENCE LLC

Practice address

11762 S State St Ste 110
Draper, UT 84020-7158

Phone

(385) 977-8125

NPI assigned

Jun 13, 2024

Organization subpart

No

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

Authorized official

Name

Gavin Lawrence

Title

Director of Development

Phone

(435) 669-7660

Specialties & licenses 1

Addresses

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.

• Devan Griner, MD

  • Plastic Surgery Physician
  • Draper, UT
  • NPI 1780895755
  Medicare reassignment NPD
• Aspen Wayment Jones, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Draper, UT
  • NPI 1013532001
  Medicare reassignment

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1588407142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11762 S STATE ST STE 110",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207158",
            "telephone_number": "385-218-0587",
            "fax_number": "385-381-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11762 S STATE ST STE 110",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207158",
            "telephone_number": "385-977-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE CLEFT CENTER FOR EXCELLENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-13",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "GAVIN",
        "authorized_official_title_or_position": "DIRECTOR OF DEVELOPMENT",
        "authorized_official_telephone_number": "435-669-7660"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawnielle Winfield
• Colin Wingrove
• Rebecca J Wingster, MHA, RN, CCM
• Kylea Winkler
• Paul W Winterton, M.D.
• Carly Wiser
• Patricia Withus, CPE
• Catherine Bergeson Woahn
• Jerome Wayne Wohleb, PHARMD
• Gina Wojnar

• Plastic Surgery Physician in Draper, UT
• Providers in Draper, UT by specialty
• Plastic Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.