Bountiful Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BOUNTIFUL SURGERY CENTER LLC

Practice address

620 Medical Dr
Suite 200
Bountiful, UT 84010-4908

Phone

(801) 296-2698

Fax

(801) 296-2122

NPI assigned

Jun 13, 2006

Organization subpart

No

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

Authorized official

Name

David McKnight

Title

VP / Cfo

Phone

(972) 789-2816

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Bountiful Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Salt Lake City, UT
  • NPI 1952720674

  3072518299

  Same PAC ID

Listed as

Bountiful Surgery Center LLCCCN 46C0001045

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Bountiful Surgery Center LLC2 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.

• Bountiful Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Salt Lake City, UT
  • NPI 1952720674
  NPD tax ID

Practitioners 1

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

• Mark E Boschert, M.D.

  • Gastroenterology Physician
  • Salt Lake City, UT
  • NPI 1346252236
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1669415451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MEDICAL DR STE 200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840105173",
            "telephone_number": "801-296-2698",
            "fax_number": "801-296-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MEDICAL DR",
            "address_2": "SUITE 200",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104908",
            "telephone_number": "801-296-2698",
            "fax_number": "801-296-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNTIFUL SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "MCKNIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP / CFO",
        "authorized_official_telephone_number": "972-789-2816"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bountiful PDC PLLC
• Bountiful Pediatrics and Neonatology Inc
• Bountiful Radiology Associates Inc
• Bountiful Ridge Anesthesia, PLLC
• Bountiful Ridge Dental, LLC
• Bountiful Surgical Associates
• Bountiful Vision Plaza PC
• Kelly Bowen, LCSW
• Maeve Bowen
• Ashlyn Bowles

• Ambulatory Surgical Clinic/Center in Bountiful, UT
• Providers in Bountiful, 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 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.