Individual provider Active NPI

Lynn Marie McMillan, NP-BC

  • Nurse Practitioner
  • Midvale, UT
National Provider Identifier
1053457085
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
268113-4405 Issued in UT
Practice address
1225 Fort Union Blvd
Suite 200
Midvale, UT 84047-1889
Phone
(801) 233-4400
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 268113-4405 UT Primary

Addresses

Primary practice location

1225 Fort Union Blvd
Suite 200
Midvale, UT 84047-1889

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 442-4950

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040414002009 UT Practitioner - Nurse Practitioner 5092700641 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
268113-4405UTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Mar 1, 2008 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Mar 27, 2012 Accepting new patients
Ihc Health Services, Inc. CurrentSince Mar 1, 2008 Accepting new patients
Ihc Health Services Inc Nurse Practitioner Current Accepting new patients

Locations

1316 N Highway 89
Farmington, UT 84025
Phone (801) 447-3361

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1170 E Gentile St
Layton, UT 84040
Phone (801) 546-3497

980 E Fort Union Blvd
Midvale, UT 84047
Phone (801) 256-0532

5801 S Fashion Blvd
Murray, UT 84107
Phone (801) 314-4185

8th Ave And C St
Salt Lake City, UT 84143
Phone (801) 350-4110

8th Ave C St
Salt Lake City, UT 84143
Phone (801) 269-2500

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

9660 S 1300 E
Sandy, UT 84094
Phone (801) 314-2417

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1053457085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-442-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 FORT UNION BLVD",
            "address_2": "SUITE 200",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471889",
            "telephone_number": "801-233-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLAN",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "268113-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

Verify at the official NPI Registry.