NPIMap

Organization Active NPI

Amsurg St George Anesthesia, LLC

  • Anesthesiology Physician
  • St George, UT
National Provider Identifier
1730452814
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
AMSURG ST GEORGE ANESTHESIA, LLC
Practice address
368 E Riverside Dr
Suite B
St George, UT 84790-6896
Phone
(435) 674-3109
Fax
(435) 674-3505
NPI assigned
Feb 20, 2012
Last updated
Aug 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Authorized official

Name
Phillip Clendenin
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

368 E Riverside Dr
Suite B
St George, UT 84790-6896

Mailing address

1A Burton Hills Blvd
Attn: Provider Enrollment
Nashville, TN 37215-6187
Phone (615) 240-3809

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120425000140 UT Part B Supplier - Clinic/Group Practice 0749442523 Receives reassigned benefits from 34 practitioners
Practice locations: St George, UT

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

368 E Riverside Dr
Ste B
St George, UT 84790
Phone (435) 674-3109

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1730452814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-240-3809",
            "fax_number": "615-234-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 E RIVERSIDE DR",
            "address_2": "SUITE B",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847906896",
            "telephone_number": "435-674-3109",
            "fax_number": "435-674-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMSURG ST GEORGE ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-20",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.