Wise Cleft Center for Excellence LLC
NPI 1588407142ActiveOrganization· Plastic Surgery· Draper, UT
Plastic Surgery in Draper, Utah, registered in NPPES in June 2024. The authorized official on file is Gavin Lawrence, Director Of Development. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1588407142 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 13, 2024 |
| Last updated in NPPES | Feb 20, 2025 |
| Certified by provider | Feb 20, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Plastic Surgery Primary | 208200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (UT) |
|---|
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