Individual provider Active NPI

Lisa Ann Ostrander, AGNP-C

  • Gerontology Nurse Practitioner
  • Taylorsville, UT
National Provider Identifier
1104398361
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
7010732-3102 Issued in UT
Practice address
1385 W 2200 S
Taylorsville, UT 84119-7205
Phone
(801) 944-0095
NPI assigned
Dec 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 7010732-3102 UT Primary

Addresses

Primary practice location

1385 W 2200 S
Taylorsville, UT 84119-7205

Mailing address

1385 W 2200 S
Taylorsville, UT 84119-7205
Phone (801) 944-0095

Other practice location 1

1208 E 3300 S
Slc, UT 84106-2522
Phone (801) 483-1600

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
I20190314001943 UT Practitioner - Nurse Practitioner 8527308394 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True North Provider Services LLCGroup PAC ID 5294219960, 2 clinicians

Practice addresses (Care Compare)

South Salt Lake, UT 84115
Phone (801) 922-4790

755 E 11TH Ave
Salt Lake City, UT 84103-3641
Phone (385) 242-6729

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Diabetes RN LLC CurrentSince Jan 14, 2024 Accepting new patients
Bluebird Medical Current Accepting new patients
Generations Medical Group LLC CurrentSince Jan 7, 2025 Accepting new patients
Taylor G Wright PC PastSince Feb 1, 2023 Accepting new patients
Finding Home Healthcare, Inc. PastSince Jul 1, 2018 Accepting new patients

Locations

612 Corporate Way
Ste 2M
Vly Cottage, NY 10989
Phone (718) 362-1403

2333 W North Temple
Slc, UT 84116
Phone (801) 539-8852

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1104398361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 W 2200 S",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841197205",
            "telephone_number": "801-944-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 W 2200 S",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841197205",
            "telephone_number": "801-944-0095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1208 E 3300 S",
            "address_purpose": "LOCATION",
            "city": "Slc",
            "state": "UT",
            "postal_code": "841062522",
            "country_code": "US",
            "telephone_number": "801-483-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSTRANDER",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-27",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "UT",
            "license": "7010732-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, UT

Sources for this page

Verify at the official NPI Registry.