Elyse E Lake, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

6168554-8900 Issued in UT

Practice address

3354 W 7800 S
West Jordan, UT 84088-4506

Phone

(801) 282-2677

Fax

(801) 282-2050

NPI assigned

Sep 30, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hunter Medical Center IncGroup PAC ID 3678461951, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IGAEAA/Endpoint/IGAEAA

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.

• Hunter Medical Center, Inc

  dba Jordan Meadows Medical Center.

  • Family Medicine Physician
  • West Jordan, UT
  • NPI 1205957131
  Medicare reassignment Care Compare group NPD
• Hunter Medical Center, Inc

  dba Jordan Meadows Medical Center

  • Family Medicine Physician
  • West Valley, UT
  • NPI 1194860569
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives Colorado

  dba Holy Cross Hospital - Jordan Valley

  • General Acute Care Hospital
  • West Jordan, UT
  • NPI 1801591391
  Care Compare affiliation

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1063721611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3534 S 6000 W",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841282610",
            "telephone_number": "801-282-2677",
            "fax_number": "801-282-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 W 7800 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884506",
            "telephone_number": "801-282-2677",
            "fax_number": "801-282-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "ELYSE",
        "middle_name": "E",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-30",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "6168554-8900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellen M Lachmar, LMFT, PHD
• Deja Laforett
• Mikayla Rae Lagana
• Vanessa Lagunas-Arevalo
• Tara Laidlaw, CSW
• Lamborn Anesthesia PC
• Loisi Langi
• Paul Tonga Langi, BACHELOR'S DEGREE
• Lauren Carissa Langley
• Azucena Langston

• Family Nurse Practitioner in West Jordan, UT
• Providers in West Jordan, 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 Dec 5, 2016; 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.