Lisa Miconi-Correa, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

200854-4408 Issued in UT

Practice address

5740 Crestwood Dr
Ogden, UT 84405-4869

Phone

(801) 479-7771

Fax

(801) 479-7795

NPI assigned

Jul 8, 2011

Sex

Female

Sole proprietor

No

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ogden Clinic PCGroup PAC ID 9638078033, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJJGBA

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.

• Ogden Clinic PC

  • Family Medicine Physician
  • Ogden, UT
  • NPI 1578550083
  Medicare reassignment Care Compare group NPD
• Ogden Clinic Specialty Services LLC

  • Sports Medicine (Family Medicine) Physician
  • Ogden, UT
  • NPI 1114203668
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbia Ogden Medical Center, Inc.

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1720031636
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1376830414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5546",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802175546",
            "telephone_number": "801-479-7771",
            "fax_number": "801-479-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5740 CRESTWOOD DR",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054869",
            "telephone_number": "801-479-7771",
            "fax_number": "801-479-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICONI-CORREA",
        "first_name": "LISA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "200854-4408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael L. Crowton DDS
• Michael M Judkins and Associates, Inc.
• Michael Woolman MD PLLC
• Richard Goodman Michaelson, MSW
• Michelle Pepper MD PC
• Erin Middleton
• Midtown Community Health Center Inc
• Midtown Community Health Center Inc
• Midtown Community Health Center Inc
• Midtown Community Health Center Inc

• Family Nurse Practitioner in Ogden, UT
• Providers in Ogden, 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 Jan 18, 2017; 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.