NPIMap

Organization Active NPI

Eastern Utah Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Price, UT
National Provider Identifier
1619048170
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
5249970-1704 Issued in UT
Legal business name
EASTERN UTAH SURGICAL CENTER
Practice address
200 N Fairgrounds Rd
Suite 1
Price, UT 84501-4205
Phone
(435) 637-1744
Fax
(435) 637-1123
NPI assigned
Nov 13, 2006
Last updated
Jun 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Jeffrey E Hansen, M.D.NPI 1386751634
Title
Medical Director
Phone
(435) 637-1744

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 5249970-1704 UT Primary

Addresses

Primary practice location

200 N Fairgrounds Rd
Suite 1
Price, UT 84501-4205

Mailing address

200 N Fairgrounds Rd
Suite 1
Price, UT 84501-4205
Phone (435) 637-1744

Other identifiers 1

IdentifierTypeStateIssuer
20034276600001OtherUTBCBS PROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

200 N Fairgrounds Rd
Ste 1
Price, UT 84501
Phone (435) 637-1174

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1619048170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N FAIRGROUNDS RD",
            "address_2": "SUITE 1",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845014205",
            "telephone_number": "435-637-1744",
            "fax_number": "435-637-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N FAIRGROUNDS RD",
            "address_2": "SUITE 1",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845014205",
            "telephone_number": "435-637-1744",
            "fax_number": "435-637-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN UTAH SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "435-637-1744",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "UT",
            "license": "5249970-1704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "20034276600001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Price, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.