Malisa May Lemon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9452542-3501 Issued in UT

Practice address

5284 S Commerce Dr Ste C134
Murray, UT 84107-5360

Phone

(801) 266-4643

NPI assigned

Sep 5, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Malisa May Park Former name

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• UT PPO
• UT PPO D-SNP

Interoperability endpoints

• Direct secure messaging: malisa.lemons.p1@direct.tannerclinic.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tanner Memorial Clinic

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1447239355
  Medicare reassignment Care Compare group NPD
• Thrive Counseling LLC

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  UT

  Medicare reassignment NPD
• Tanner Memorial Clinic

  • Multi-Specialty Clinic/Center
  • Layton, UT
  • NPI 1538951165
  NPD
• Tanner Memorial Clinic

  • Family Medicine Physician
  • Layton, UT
  • NPI 1760934533
  NPD
• Rosenberg Cooley Metcalf LC

  • Orthopaedic Surgery Physician
  • Park City, UT
  • NPI 1649374216
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1043645351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5284 S COMMERCE DR STE C134",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075360",
            "telephone_number": "801-266-4643",
            "fax_number": "801-266-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5284 S COMMERCE DR STE C134",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075360",
            "telephone_number": "801-266-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMON",
        "first_name": "MALISA",
        "middle_name": "MAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-05",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-37096",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-33625",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "139792",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-1165",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "9452542-3501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14495254",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALISA",
            "last_name": "PARK",
            "middle_name": "MAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Harry Axel Leibovich Jr., BC-HIS
• Harry Axel Leibovich, BS, BC-HIS, ACA
• Richard Greg Leininger, M.D.
• Amy Lynne Leiseth, PT
• John Walker Lelis, PA-C
• Blair E. Lenhan, MD
• Marianne Lentz
• Kyra Leonard, PHARMD
• Shannon Mary Lesnevich, DPT
• Jason Reid Lesser, MSN, FNP-C

• Clinical Social Worker in Murray, UT
• Providers in Murray, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.