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NUVISTA PLASTIC SURGERY
NPI 1346597507
Clinic/Center - Medical Specialty in Salt Lake City, UT

Active since August 07, 2012CLIA 46D2056118 · Waiver
5353 S 960 E, #150, SALT LAKE CITY, UT 84117(801) 261-5791(801) 747-7740 Get Directions Write a Review

NPPES record last updated: August 30, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nuvista Plastic Surgery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NUVISTA PLASTIC SURGERY (NPI 1346597507) is a healthcare organization registered as a medical specialty in Salt Lake City, Utah and active in the NPI registry since August 2012. The organization holds a CLIA Waiver certificate valid through March 20, 2027 and lists Jason Dayne Petersen, President, as its authorized official.

NPPES Registry Identity

NPI1346597507
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameJ. DAYNE PETERSEN M.D., PC
Location Address5353 S 960 E, #150Salt Lake City, UT 84117-3569
Mailing Address5353 S 960 E, #150Salt Lake City, UT 84117-3569 · (801) 261-5791 · Fax (801) 747-7740
Phone(801) 261-5791
Fax(801) 747-7740
Organization SubpartNo
Authorized OfficialJason Dayne PetersenPresident · (801) 971-8684
Enumeration DateAugust 7, 2012
Last NPPES UpdateAugust 30, 2012
✔ NPI 1346597507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in UT · 83185641205
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
5353 S 960 E, Salt Lake City, UT 84117
Open in Google Maps ↗

Other Names 1

Doing Business AsNuvista Plastic Surgery

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2056118

Nuvista Plastic Surgery · Draper, UT
Active · expires Mar 20, 2027
CLIA Number46D2056118
Laboratory TypePhysician Office
Certificate Effective DateMarch 21, 2025
Certificate Expiration DateMarch 20, 2027
Laboratory DirectorJ Dayne D. Petersen
Laboratory Phone(801) 261-5791
Laboratory LocationNuvista Plastic Surgery10 West Scenic Point Drive #103, Draper, UT 84020
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MATTHEW V. DAVIES PH.D.
Psychologist (Forensic)
5353 S 960 E, SUITE 230
MURRAY, UT 84117
Salt Lake County (801) 263-3335
ERIC MCKEON PHARMD
Pharmacist
5353 S 960 E
SALT LAKE CITY, UT 84117
Salt Lake County (801) 288-4013
MONICA D CHRISTY PHD PC
Psychologist (Clinical)
5353 S 960 E, SUITE 230
MURRAY, UT 84117
Salt Lake County (801) 263-3335
DR. JASON DAYNE PETERSEN MD
Plastic Surgery (Plastic Surgery Within the Head and Neck)
5353 S 960 E, #150
SALT LAKE CITY, UT 84117
Salt Lake County (801) 261-5791
KYUNGSUN JEONG KIM PHARM D
Pharmacist
5353 S 960 E, #103
SALT LAKE CITY, UT 84117
Salt Lake County (801) 288-4013
JESSICA BLANCHARD PHARMD
Pharmacist
5353 S 960 E
SALT LAKE CITY, UT 84117
Salt Lake County (801) 288-4013

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is J. Dayne Petersen M.D., PC's NPI number?

The NPI number for J. Dayne Petersen M.D., PC is 1346597507. It was assigned to this organization in the NPPES registry on August 7, 2012. The provider is doing business as Nuvista Plastic Surgery.

Where is J. Dayne Petersen M.D., PC located?

J. Dayne Petersen M.D., PC is located at 5353 S 960 E #150, Salt Lake City, UT 84117. The listed phone number is (801) 261-5791.

What is J. Dayne Petersen M.D., PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Does J. Dayne Petersen M.D., PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2056118) is associated with this NPI, valid through March 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for J. Dayne Petersen M.D., PC was last updated on August 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.