OrganizationActive
Plastics Clinic LLC
NPI 1184318826 · Plastic Surgery Physician · South Jordan, UT
Provider details
- NPI number
- 1184318826
- Entity type
- Organization
- Primary specialty
- Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tim Prusse, Manager(801) 386-1337
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1309 W South Jordan Pkwy Ste 110
South Jordan, UT 84095-9014
Phone: (801) 839-5557
Fax: (801) 770-4455
Street-level locationGet directions
Mailing address
1309 W South Jordan Pkwy Ste 110
South Jordan, UT 84095-9014
Registry dates
- Enumerated
- 2023-06-06
- Last updated
- 2023-10-31
- Certified
- 2023-10-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.