Lu Ann Jacobs-Peterson, APRN FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

219855-4405 Issued in UT

Practice address

2376 N 400 E Ste 205
Tooele, UT 84074-3413

Phone

(435) 882-8111

Fax

(435) 882-2111

NPI assigned

Apr 9, 2008

Last updated

Apr 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• General Surgery at Northpointe, LLC

  • Surgery Physician
  • Tooele, UT
  • NPI 1164782496
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Cedar Creek Family Health Care LLC

  • Clinic/Center
  • Tooele, UT
  • NPI 1639323280
  NPD (past) Authorized official
• Ihc Health Services Inc

  dba Logan Clinic

  • Clinic/Center
  • Logan, UT
  • NPI 1376688416
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Kimberly E Beck MD PC

  • Family Medicine Physician
  • Gunnison, UT
  • NPI 1821270364
  NPD (past)

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1396918462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14540 S MAJESTIC OAKS LN",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840963645",
            "telephone_number": "801-232-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 N 400 E STE 205",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840743413",
            "telephone_number": "435-882-8111",
            "fax_number": "435-882-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Harris Village Clinic",
            "address_2": "251 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Tooele",
            "state": "UT",
            "postal_code": "84074",
            "country_code": "US",
            "telephone_number": "435-228-5151 x904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS-PETERSON",
        "first_name": "LU ANN",
        "credential": "APRN   FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "219855-4405",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "219855-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ihc Health Services, Inc. (Tooele Valley Dialysis)
• Infocus Optics LLC (Infocus Optical)
• Integrate Psychotherapy PLLC
• Itooth, LLC
• Mark R. Jackson, MD
• Carin Renee James
• Chad Jarvis, DA-C
• Jay M. Spector,M.D.,LLC (Oasis Family Medicine)
• Jed C Winder OD, PC (Tooele Vision Center)
• Candice Jemison

• Nurse Practitioner in Tooele, UT
• Providers in Tooele, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.