Corrie Lamoreaux Stapleton, NP
Individual provider Active NPI Nurse Practitioner · American Fork, UT
NPI 1225796451 · NPPES record last updated Dec 28, 2023
Key facts
- NPI
- 1225796451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 10832313-4405 (UT)
- Practice address
- 1112 E 300 N Ste 202
American Fork, UT 84003-2484 - Phone
- (801) 577-7055
- NPI assigned
- Dec 5, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220204002128 | UT | Practitioner - Nurse Practitioner | 0042603557 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10832313-4405 | UT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Family Medical - Vineyard | Current |
Accepting new patients | |
| Premier Family Medical | Current | Accepting new patients | |
| Premier Family Medical - City Center | Current |
Accepting new patients | |
| Option Care Infusion Suites, LLC | Past | Accepting new patients |
Locations
3943 E Pony Express Pkwy
Ste 120
Eagle Mountain, UT 84005
Phone (801) 443-1184
275 W 200 N
Lindon, UT 84042
Phone (801) 796-1333
830 N 2000 W
Pleasant Grv, UT 84062
Phone (801) 756-3511
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 10832313-4405 | UT | Yes |
Addresses
Primary practice location
1112 E 300 N Ste 202
American Fork, UT 84003-2484
Mailing address
1112 E 300 N Ste 202
American Fork, UT 84003-2484
Phone (801) 577-7055
Other practice location 1
348 E 4500 S Ste 220
Murray, UT 84107-8524
Phone (801) 577-7055
Other practice location 2
295 S 1470 E
St George, UT 84790-1961
Phone (801) 577-7055
Other practice location 3
2132 N Robins Dr Ste 210
Layton, UT 84041-7060
Phone (801) 577-7055
Other practice location 4
3943 E Pony Express Pkwy Ste 120
Eagle Mountain, UT 84005-5543
Phone (801) 789-5566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10832313-8900 | Other | UT | APRN CONTROLLED SUBSTANCE SCHEDULE 2-5 LICENSE |
| 10832313-4405 | Other | UT | STATE APRN LICENSE |
Other providers in American Fork, UT
- Stefanie Sparks
- Elizabeth Hedgepeth Spencer
- Tiffany Marnell Spencer
- SRS-American Fork, LLC
- Karla L Standage
- Star Kids
- Joyce Elaine Starks
- Brandie Statham
- Tiffany Steck
- Robert Blake Steele
All providers in American Fork, UT · Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.