Lucretia Stallings

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12358017-3501 Issued in UT

Practice address

415 Medical Dr Ste 100
Bountiful, UT 84010-4946

Phone

(801) 683-1062

NPI assigned

Jan 28, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Utah School of Medicine, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Utah Partners for Health

  dba Mid-Valley Health Clinic

  • Clinic/Center
  • Midvale, UT
  • NPI 1508299892
  Medicare reassignment NPD
• Utah Partners for Health

  • Community/Retail Pharmacy
  • West Jordan, UT
  • NPI 1861068082
  NPD

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

{
    "created_epoch": "1517097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1366940066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE 100",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104946",
            "telephone_number": "801-683-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MEDICAL DR STE 100",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104946",
            "telephone_number": "801-683-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLINGS",
        "first_name": "LUCRETIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-28",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "12358017-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sports Medicine Specialists, LLC
• Sportsmed Physical Therapy of Bountiful a Professional Corp
• Squire Boys, Inc.
• Janet Ruth Squire
• Reyna St Germain, DNP, FNP-BC
• Standard Optical Co
• Jeremy Joseph Stanger, PHARM.D.
• Matthew I Starsiak
• Bayleigh Steed
• June Michelle Steely, MD

• Clinical Social Worker in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.