ADVANCED SURGERY CENTER OF NORTHERN UTAH
NPI 1104301613
Clinic/Center - Ambulatory Surgical in Logan, UT

NPI Status: Active since October 01, 2018

Contact Information

55 EAST GOLF COURSE ROAD
LOGAN, UT
ZIP 84321
Phone: (435) 760-3734

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 46D2156197
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 10-10-2026

About ADVANCED SURGERY CENTER OF NORTHERN UTAH

This page provides the complete NPI Profile along with additional information for Advanced Surgery Center Of Northern Utah, a provider established in Logan, Utah operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1104301613 assigned on October 2018. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Advanced Surgery Center Of Northern Utah. The authorized official of this NPI record is Mrs. Marielle Whitlock R.n. (Administrator)

NPI
1104301613
Provider Legal Name
LOGAN SURGICAL SUITES LLC
Other Organization Name
ADVANCED SURGERY CENTER OF NORTHERN UTAH
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
55 EAST GOLF COURSE ROAD LOGAN, UT 84321
Location Phone
(435) 760-3734
Mailing Address
55 EAST GOLF COURSE ROAD LOGAN, UT 84321
Mailing Phone
(435) 787-7190
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-01-2018
Last Update Date
09-23-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BridgeSpan Standard Bronze Plan - HMO
  • BridgeSpan Standard Gold Plan - HMO
  • BridgeSpan Standard Silver Plan - HMO
  • Bronze Essential 9000 Deductible With 4 Copay No Deductible Office Visits - EPO
  • Bronze HSA 7000 - EPO
  • Gold 2300 - EPO
  • Regence Standard Bronze 7500 - EPO
  • Regence Standard Gold 2000 - EPO
  • Regence Standard Silver 6000 - EPO
  • Silver 6500 - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. MARIELLE WHITLOCK R.N.

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(435) 760-3734

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Anchoring of biceps tendon

Anchoring of the biceps tendon is a surgical procedure aimed at restoring stability to your arm. The surgeon secures your biceps tendon to the bone using special anchors, which helps to reduce pain and improve arm function.

This service was performed 12 times for 12 patients

Heat destruction of intraosseous basivertebral nerve in bones of spine in lower back, first two bones

This procedure involves the use of heat to disable the basivertebral nerve within the first two bones of your lower spine. It's done to alleviate chronic lower back pain. It's a safe, minimally invasive procedure with a quick recovery time.

This service was performed 17 times for 17 patients

Incision of tendon covering of finger

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

This service was performed 23 times for 14 patients

Injection, bupivacaine liposome, 1 mg

Bupivacaine liposome is a local anesthetic used to numb a specific area of the body and reduce pain or discomfort associated with surgical procedures. The 1 mg dosage is injected by a healthcare professional at the required site.

This service was performed 7,583 times for 54 patients

Release and/or relocation of hand nerve

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

This service was performed 27 times for 24 patients

Repair of shoulder rotator cuff using an endoscope

This procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.

This service was performed 13 times for 13 patients

Replacement of knee joint, both sides of knee

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

This service was performed 68 times for 63 patients

Replacement of thigh bone and hip joint with prosthesis

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

This service was performed 19 times for 17 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
46D2156197
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
October 11, 2024
Certificate Expiration Date
October 10, 2026
Laboratory Director
DAVID M. ROWLEY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Advanced Surgery Center Of Northern Utah to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1104301613, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
3
Doubled → 6
Pos 6
0
Unchanged
Pos 7
1
Doubled → 2
Pos 8
6
Unchanged
Pos 9
1
Doubled → 2
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 3 → 6 1 → 2 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 0 + 4 + 6 + 0 + 2 + 6 + 2 + 24 = 47

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 47 is 50. The difference is the calculated check digit.

50 - 47 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1104301613.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104301613, enumerated as an "organization" on October 01, 2018.

The provider is located at 55 EAST GOLF COURSE ROAD LOGAN, UT 84321 and the phone number is (435) 760-3734.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: BridgeSpan Health Company and Regence BlueCross. Please consult your insurance carrier or call the provider to verify.