South Town Surgery Group, LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

SOUTH TOWN SURGERY GROUP, LLC

Practice address

10011 S Centennial Pkwy
Sandy, UT 84070-4156

Phone

(501) 404-7246

NPI assigned

May 6, 2015

Organization subpart

No

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

Authorized official

Name

Carolina Dela Pava

Title

Administrator

Phone

(501) 404-7246

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1992182216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1944",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840911944",
            "telephone_number": "501-404-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10011 S CENTENNIAL PKWY",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840704156",
            "telephone_number": "501-404-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TOWN SURGERY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "status": "A",
        "authorized_official_last_name": "DELA PAVA",
        "authorized_official_first_name": "CAROLINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-404-7246"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Sandy, UT
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• Health Maintenance Organization in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.