Individual provider Active NPI

Michelle Lancaster

  • Family Nurse Practitioner
  • South Jordan, UT
National Provider Identifier
1265049811
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
90210024405 Issued in UT
Practice address
10436 S 1055 W
South Jordan, UT 84095-1529
Phone
(385) 432-5183
NPI assigned
Sep 28, 2020
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 90210024405 UT Primary
General Practice Registered Nurse 163WG0000X 9021002-3102 UT

Addresses

Primary practice location

10436 S 1055 W
South Jordan, UT 84095-1529

Mailing address

5411 W Rosemill Dr
Riverton, UT 84096-7904

Other practice location 1

3369 W Mayflower Ave
Lehi, UT 84048-3089
Phone (385) 270-8396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20260514004580 CO Practitioner - Nurse Practitioner 9133698566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Goodness Health, LLCGroup PAC ID 1850694985, 61 clinicians

Practice addresses (Care Compare)

925 N Lincoln St
Apt 15a
Denver, CO 80203-2768
Phone (720) 500-5488

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9021002-3102UTMDGeneral Practice Registered Nurse
90210024405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ketamine for Depression Salt Lake City LLC Family CurrentSince Mar 20, 2025 Accepting new patients
Goodness Health, LLC CurrentSince May 5, 2026 Accepting new patients
Goodness Health, LLC PastSince May 5, 2026 Accepting new patients

Locations

201 E 5900 S
Ste 200
Murray, UT 84107
Phone (385) 474-6946

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1265049811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5411 W ROSEMILL DR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10436 S 1055 W",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840951529",
            "telephone_number": "385-432-5183"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3369 W Mayflower Ave",
            "address_purpose": "LOCATION",
            "city": "Lehi",
            "state": "UT",
            "postal_code": "840483089",
            "country_code": "US",
            "telephone_number": "385-270-8396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "90210024405",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "UT",
            "license": "9021002-3102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.