Stone Mountain Surgical, LLC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

STONE MOUNTAIN SURGICAL, LLC

Practice address

6804 S 1300 E
Cottonwood Heights, UT 84121-2882

Phone

(801) 571-2295

Fax

(801) 206-3770

NPI assigned

Mar 29, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Blake Seifers

Title

Owner

Phone

(801) 571-2295

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1790280816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6905 S 1300 E STE 161",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471817",
            "telephone_number": "801-571-2295",
            "fax_number": "801-206-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6804 S 1300 E",
            "city": "COTTONWOOD HEIGHTS",
            "state": "UT",
            "postal_code": "841212882",
            "telephone_number": "801-571-2295",
            "fax_number": "801-206-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE MOUNTAIN SURGICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "SEIFERS",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-571-2295",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Stillman, LCSW
• Jamii Lyn Stock
• Morgan Stocksdale
• Hannah Stoker
• Taylor C Stoker
• Jennifer Jill Stone, APRN PMHNP
• Megan Sturdevant, MA, ACMHC
• William Patrick Sullenger
• Ella Suprise
• Surgical Synergy, LLC

• Customized Equipment (DME) in Cottonwood Heights, UT
• Providers in Cottonwood Heights, UT by specialty
• Customized Equipment (DME) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.