Lisa Shea Roberts, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8689112-4405 Issued in UT

Practice address

55 E 100 N
Suite 303
Logan, UT 84321-4661

Phone

(435) 760-7078

NPI assigned

Jul 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12929/brand/1/csg/1/fhir/r4

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.

• Springcreek Medical Center PC

  • Chiropractor
  • Providence, UT
  • NPI 1093075756
  Medicare reassignment NPD
• Sage Functional Medicine Center

  • Primary Care Clinic/Center
  • Logan, UT
  • NPI 1912368549
  NPD (past) Authorized official

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1043652803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12965 W 61ST CIR",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800043981",
            "telephone_number": "435-760-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E 100 N",
            "address_2": "SUITE 303",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214661",
            "telephone_number": "435-760-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LISA",
        "middle_name": "SHEA",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "UT",
            "license": "8689112-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8689112-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Denice Rivera
• Josefina Antonia Rizzo
• Robert E. Baldwin
• Robert L B Stevenson
• Linda Jones Roberts, APRN
• Sara Roberts, PHARMD
• Jeanice Alexandra Robins
• Robinson Audiology, LLC.
• Aubrey Robinson, LCMHC
• David M Robinson, AUD

• Family Nurse Practitioner in Logan, UT
• Providers in Logan, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.