Wasatch Surgical LLC · Surgery Physician

1893 E Millbrook Rd, Salt Lake City, UT 84106-3827

Overview

Wasatch Surgical LLC is a Surgery Physician (organization) practicing in Bountiful, Utah. The National Provider Identifier (NPI) is #1053201525, which was assigned on July 7, 2025, and the registration record was last updated on July 7, 2025. The practitioner's main practice location is at 520 Medical Dr Ste 300, Bountiful, UT 84010-8925; the contact telephone number is 2282739021. The primary taxonomy of Wasatch Surgical LLC is Surgery Physician (208600000X). The authorized official for Wasatch Surgical LLC is Mackenzie Lee Goodwin (Owner).

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Provider Information

NPI 1053201525
Entity Type Organization
Organization Name WASATCH SURGICAL LLC
Provider Name WASATCH SURGICAL LLC
Practice Address 520 Medical Dr Ste 300
Bountiful
UT 84010-8925
Practice Telephone 2282739021
Mailing Address 1893 E Millbrook Rd
Salt Lake City
UT 84106-3827
Mailing Telephone 2282739021
Certification Date 2025-07-07
Enumeration Date 2025-07-07
Last Update Date 2025-07-07
Is Organization Subpart N

Authorized Official Information

Official Name MACKENZIE LEE GOODWIN
Official Title OWNER
Credential MD
Telephone 2282739021

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y208600000XSurgery193200000X MULTI-SPECIALTY GROUP

Other Provider Names

Other Organization NameType
Mackenzie Goodwin MDDoing Business As Name

Secondary Practice Locations

AddressTelephoneFax
74 Kimballs Lane, Bldg 2, Suite 260, Draper, UT 840202282739021

Taxonomy Information

Primary Taxonomy

Code 208600000X
Taxonomy Surgery Physician
Classification Surgery
Grouping Allopathic & Osteopathic Physicians
Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Apex Surgical Solutions LLC 16220 N Scottsdale Rd Ste 300k, Scottsdale, AZ 85254-1798Surgery Physician2026-02-07
Urgent Specialty Associates of Missouri LLC 19550 E 39th St S Ste 325, Independence, MO 64057-2310Surgery Physician2026-01-26
Jms Surgical PLLC 12530 Lebanon Rd Ste 205, Frisco, TX 75035-9473Surgery Physician2026-01-06
Diego Surgical Inc. 1317 Oakdale Rd Ste 420, Modesto, CA 95355-3364Surgery Physician2026-02-02
Alvarez Surgical Services LLC 8035 N Mastern Ave, Parkville, MO 64152-4003Surgery Physician2026-01-06
Honorhealth Ambulatory 4545 N Hunt Hwy Ste 100, Florence, AZ 85132-6937Surgery Physician2026-02-06
North Indy Surgical LLC 2160 W 86th St Ste 202a, Indianapolis, IN 46260-1908Surgery Physician2026-01-22
Norfolk Health Care 150 W Brambleton Ave Apt 512, Norfolk, VA 23510-2056Surgery Physician2026-01-28
Susan M Apte Md 9441 Health Center Dr, Land O Lakes, FL 34637-5837Surgery Physician2026-01-15
Jennifer Johannes PLLC 332 S 5th St, Montrose, CO 81401-5705Surgery Physician2026-01-16
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Location Information

Street Address 1893 E MILLBROOK RD
City SALT LAKE CITY
State UT
Zip Code 84106-3827
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Rick George Lambert · Riki George Lambert 3098 Highland Dr #305, Salt Lake City, UT 84106Clinical Social Worker2006-08-21
Samuel Fuller 3440 S 500 E Apt 88, Salt Lake City, UT 84106-1280Social Worker2016-07-25
Sophie Mckaye Wooton 1240 E Stringham Ave Apt 107, Salt Lake City, UT 84106-1037Registered Dietitian2025-06-05
Eric Stedman 3802 S 700 E, Salt Lake City, UT 84106-1182Child & Adolescent Psychiatry Physician2007-05-24
Adeline Rae Chavis 3855 S 700 E, Millcreek, UT 84106-1157Recreational Therapist Assistant2025-06-09
Associated Counseling Services, LLC 2237 S 600 E, Salt Lake City, UT 84106-1429Counselor2006-03-02
Kilea Sorelle Bucher 617 E Spring View Dr, South Salt Lake, UT 84106-1211Case Manager/Care Coordinator2025-10-21
Happy Homez Agency LLC 3761 S 700 E Ste 170a, Salt Lake City, UT 84106-1100Foster Care Agency2025-05-15
Angela L Stefani 1240 E Stringham Ave Apt 403, Salt Lake City, UT 84106-1031General Practice Registered Nurse2026-01-05
Utah Cancer Specialists PC 3838 S 700 E, Ste 100, Salt Lake City, UT 84106-1466Nurse Practitioner2007-01-16
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Providers with similar names

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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.