Individual provider Active NPI

Roberta Ann Lucas, APRN

  • Adult Health Nurse Practitioner
  • Murray, UT
National Provider Identifier
1568538528
Registry record updated Sep 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
225-249-4405 Issued in UT
Practice address
835 E 4800 S
Murray, UT 84107-5040
Phone
(801) 622-5418
NPI assigned
Nov 28, 2006
Last updated
Sep 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 225-249-4405 UT Primary
Occupational Health Nurse Practitioner 363LX0106X 225-249-4405 UT

Addresses

Primary practice location

835 E 4800 S
Murray, UT 84107-5040

Mailing address

8144 S Oak Creek Dr
Sandy, UT 84093-6515
Phone (801) 891-3680

Other practice location 1

1950 Fort Union Blvd
Salt Lake City, UT 84121-6894
Phone (801) 943-3300

Other practice location 2

8302 S Brighton Loop Rd
Brighton, UT 84121-9737
Phone (435) 655-3205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
225-249-4405UTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. Past Accepting new patients
Emergency Physicians Integrated Care, LLC Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1568538528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8144 S OAK CREEK DR",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936515",
            "telephone_number": "801-891-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 E 4800 S",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075040",
            "telephone_number": "801-622-5418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 Fort Union Blvd",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841216894",
            "country_code": "US",
            "telephone_number": "801-943-3300",
            "fax_number": "801-943-3461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8302 S Brighton Loop Rd",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "UT",
            "postal_code": "841219737",
            "country_code": "US",
            "telephone_number": "435-655-3205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "ROBERTA",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "UT",
            "license": "225-249-4405",
            "primary": true
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "UT",
            "license": "225-249-4405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.