NPIMap

Individual provider Active NPI

Lori E Witter, MD

  • Family Medicine Physician
  • West Valley City, UT
National Provider Identifier
1164474268
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6171720-1205 Issued in UT
Practice address
3730 W 4700 S
West Valley City, UT 84118-3457
Phone
(801) 213-9200
NPI assigned
May 17, 2006
Last updated
Feb 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6171720-1205 UT Primary

Addresses

Primary practice location

3730 W 4700 S
West Valley City, UT 84118-3457

Mailing address

PO Box 510708
Salt Lake City, UT 84151-0708
Phone (801) 587-6600

Other names 1

  • Dr. Lori E Boughton Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lwitter1220395@direct.trinity-health.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050422000734 OH Practitioner - Family Practice 8123066743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Carmel Healthproviders IncGroup PAC ID 9537073804, 140 clinicians

Practice addresses (Care Compare)

1045 Beecher Crossing N
Gahanna, OH 43230-4573

55 N High St
New Albany, OH 43054-7099
Phone (614) 627-1878

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6171720-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Carmel Healthproviders Inc Family Medicine CurrentSince Jul 15, 2013 Accepting new patients
Mount Carmel Health Providers Inc Family Medicine CurrentSince Jul 15, 2013 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

6150 E Broad St
Rm WD210
Columbus, OH 43213

55 N High St
New Albany, OH 43054
Phone (614) 627-1878

7277 Smiths Mill Rd
Ste 105
New Albany, OH 43054
Phone (614) 627-1878

Organizations & group practices 4

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.

Hospital & facility affiliations 9

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1164474268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510708",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841510708",
            "telephone_number": "801-587-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 W 4700 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841183457",
            "telephone_number": "801-213-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTER",
        "first_name": "LORI",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "6171720-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwitter1220395@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mount Carmel Health Columbus Direct Access",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "55 N High St",
            "city": "New Albany",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430547099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "BOUGHTON",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.