Individual provider Active NPI

Lynn Marie Mulvihill, RD

  • Physician Assistant
  • Salt Lake City, UT
National Provider Identifier
1619179140
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8415704-1206 Issued in UT
Practice address
4465 S 900 E
Suite 200
Salt Lake City, UT 84124-2469
Phone
(801) 266-2777
NPI assigned
Jun 5, 2007
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 8415704-1206 UT
Physician Assistant 363A00000X 8415704-1206 UT Primary

Addresses

Primary practice location

4465 S 900 E
Suite 200
Salt Lake City, UT 84124-2469

Mailing address

2151 E Meadow Lark Way
Sandy, UT 84093-2644
Phone (517) 410-5719

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121218000395 UT Practitioner - Physician Assistant 2567545171 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 19, 2016 Accepting new patients
Ihc Health Services Inc CurrentSince Sep 2, 2019 Accepting new patients
Ihc Health Services Inc Physician Assistant CurrentSince Aug 19, 2016 Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

324 Tenth Ave
#163
Salt Lake Cty, UT 84103

324 Tenth Ave
Slc, UT 84103
Phone (801) 408-5735

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 6

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": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1619179140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 E MEADOW LARK WAY",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840932644",
            "telephone_number": "517-410-5719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 S 900 E",
            "address_2": "SUITE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841242469",
            "telephone_number": "801-266-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULVIHILL",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "8415704-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8415704-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.