Bountiful Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BOUNTIFUL SURGERY CENTER, LLC

Doing business as

Mountain West Endoscopy Center

Practice address

6360 S 3000 E Ste 320
Salt Lake City, UT 84121-6932

Phone

(801) 944-3166

NPI assigned

Apr 9, 2014

Last updated

Sep 10, 2026By the provider in NPPES

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

Other names 1

• Mountain West Endoscopy Center Doing business as

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
  • Bountiful, UT
  • NPI 1669415451

  3072518299

  Same PAC ID

Listed as

Bountiful Surgery Center LLCCCN 46C0001020

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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
  • Bountiful, UT
  • NPI 1669415451
  NPD tax ID

Member of 1

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

• Utah Gastroenterology

  • Gastroenterology Physician
  • Sandy, UT
  • NPI 1124837646

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1952720674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 S 3000 E STE 320",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216932",
            "telephone_number": "801-944-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 S 3000 E STE 320",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216932",
            "telephone_number": "801-944-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOUNTIFUL SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-09",
        "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": [
        {
            "organization_name": "Mountain West Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anne E Boulter, APRN
• Nicole Kay Bouma
• Michael T. Bounajem, MD
• Matt C Bounds
• Tyndall Bounous
• Seth Powell Bourgeous
• Bourget Health Services, Inc (Pathology Associates Medical Laboratories)
• Michael H Bourne, MD
• Michael Hal Bourne Jr., MD
• Robert B Bourne, MD

• Ambulatory Surgical Clinic/Center in Salt Lake City, UT
• Providers in Salt Lake City, 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.