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Form Surgery Center LLC

Ambulatory Surgical Clinic/Center in Salt Lake City, UT · enumerated 2017 · authorized official Janie Ward, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1457863912

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Registry record

Entity type Organization (Type 2)
Legal business name Form Surgery Center LLC
Practice address 6322 S 3000 E Ste 170, Salt Lake City, UT, 84121
Phone (801) 513-3223
Enumeration date Oct 24, 2017
Last updated in NPPES Apr 5, 2021

Taxonomy & classification

261QA1903X Ambulatory Surgical Clinic/Center Ambulatory Health Care Facilities · License 4972C (UT) Primary

Authorized official

Name Janie Ward
Title Owner
Phone (801) 513-3223

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Form Surgery Center LLC?
The NPI for Form Surgery Center LLC is 1457863912, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Form Surgery Center LLC?
NPPES lists Janie Ward (Owner) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-04-05.