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LAKEVIEW NEUROSURGERY CLINIC, LLC
NPI 1831202118
Psychiatry & Neurology - Neurology in Bountiful, UT

Active since August 17, 2006CLIA 46D0688362 · Microscopy
620 MEDICAL DR, SUITE 300, BOUNTIFUL, UT 84010(801) 299-3871 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lakeview Neurosurgery Clinic, Llc NPPES

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

LAKEVIEW NEUROSURGERY CLINIC, LLC (NPI 1831202118) is a healthcare organization registered as a neurology in Bountiful, Utah and active in the NPI registry since August 2006. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Jeff Rydburg, Vp, as its authorized official.

NPPES Registry Identity

NPI1831202118
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NameLAKEVIEW NEUROSURGERY CLINIC, LLC
Location Address620 MEDICAL DR, SUITE 300Bountiful, UT 84010-5084
Mailing Address620 Medical Dr, Suite 300Bountiful, UT 84010-5084 · (801) 299-3871
Phone(801) 299-3871
Organization SubpartNo
Authorized OfficialJeff RydburgVp · (801) 299-3871
Enumeration DateAugust 17, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1831202118 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Definition

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

620 MEDICAL DR, Bountiful, UT 84010
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 for Provider-Performed Microscopy Procedures (PPMP) 46D0688362

Lakeview Ob/Gyn · Bountiful, UT
Active · expires Aug 31, 2026
CLIA Number46D0688362
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRyan G. Porter MD
Laboratory Phone(801) 299-2229
Laboratory LocationLakeview Ob/Gyn620 Medical Drive, Ste 340, Bountiful, UT 84010
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

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

DR. MOLLY MEARS MD
Obstetrics & Gynecology
620 MEDICAL DR, SUITE 340
BOUNTIFUL, UT 84010
Davis County (801) 299-2229
MR. NATHAN C WARD MD
Obstetrics & Gynecology
620 MEDICAL DR, SUITE 340
BOUNTIFUL, UT 84010
Davis County (801) 299-2229
MR. WALLACE D SMITH MD
Obstetrics & Gynecology
620 MEDICAL DR, SUITE 340
BOUNTIFUL, UT 84010
Davis County (801) 299-2229
DR. JACQUELINE K GIANNINI MD
Pediatrics
620 MEDICAL DR, SUITE 100
BOUNTIFUL, UT 84010
Davis County (801) 295-2888
DR. DANIEL SHANE SELLERS M.D.
Plastic Surgery (Surgery of the Hand)
620 MEDICAL DR, SUITE 310
BOUNTIFUL, UT 84010
Davis County (801) 295-6554
DR. THOMAS D COPPIN MD
Pathology (Anatomic Pathology & Clinical Pathology)
620 MEDICAL DR
BOUNTIFUL, UT 84010
Davis County (801) 299-2125
LAKEVIEW NEUROSURGERY CLINIC, LLC
Neurological Surgery
620 MEDICAL DR, SUITE 300
BOUNTIFUL, UT 84010
Davis County (801) 299-3871
LAKEVIEW NEUROSURGERY CLINIC LLC
Neurological Surgery
620 MEDICAL DR, SUITE 300
BOUNTIFUL, UT 84010
Davis County (801) 299-3871

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 Lakeview Neurosurgery Clinic, LLC's NPI number?

The NPI number for Lakeview Neurosurgery Clinic, LLC is 1831202118. It was assigned to this organization in the NPPES registry on August 17, 2006.

Where is Lakeview Neurosurgery Clinic, LLC located?

Lakeview Neurosurgery Clinic, LLC is located at 620 Medical Dr Suite 300, Bountiful, UT 84010. The listed phone number is (801) 299-3871.

What is Lakeview Neurosurgery Clinic, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Does Lakeview Neurosurgery Clinic, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 46D0688362) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lakeview Neurosurgery Clinic, LLC was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.