Lisa A Barkdull, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8721544-4405 Issued in UT

Practice address

450 S 900 E Ste 175
Salt Lake City, UT 84102-2981

Phone

(801) 456-2333

Fax

(801) 456-2330

NPI assigned

May 31, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/d540673c-303d-49d9-a9e1-a1fb4df27dc9/

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

• The Performing, Endurance, and Artistic Athlete Clinic, PLLC

  dba The PEAAC

  • Sports Medicine (Family Medicine) Physician
  • Millcreek, UT
  • NPI 1043919889
  Medicare reassignment NPD
• C and B Family Practice LLC

  dba C and B Family Practice

  • Nurse Practitioner
  • Altonah, UT
  • NPI 1841825213
  NPD (past)
• Ear Nose & Throat Specialists of Northern VA

  • Otolaryngology Physician
  • Springfield, VA
  • NPI 1760588628
  NPD (past)

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1114920402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275W 200 N 7",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371873",
            "telephone_number": "801-546-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S 900 E STE 175",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022981",
            "telephone_number": "801-456-2333",
            "fax_number": "801-456-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1481 Renaissance Pl",
            "address_purpose": "LOCATION",
            "city": "Pleasant Grove",
            "state": "UT",
            "postal_code": "840629502",
            "country_code": "US",
            "telephone_number": "703-678-9863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARKDULL",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "F.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-31",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WV",
            "license": "0389765-22",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024166259",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8721544-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aogden@mobilenpcare.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "aogden@mobilenpcare.com",
            "address_1": "450 S 900 E Ste 175",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841022981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexej Barg, M.D.
• Brandon Bargeloh
• Bariatric Medicine Institute
• Bariatric Surgery Affiliates LLC
• E. Kay Barickman, PH.D.
• Matthew Barkdull
• Andrea Michelle Barker, PA-C, MPAS
• Anna Barker
• Annelise Barker
• Blase Barker

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, 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 1, 2021; 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.