Active NPI
Eric Raymond Lang
- Family Nurse Practitioner
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 7847331-4405
- Practice address
- 1055 N 500 W W
Building a
Provo, UT 84604 - Phone
- (801) 812-5033
- Fax
- (801) 812-5034
- NPI assigned
- Aug 25, 2025
- Last updated
- Dec 8, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 7847331-4405 | UT | Primary |
| Primary Care Nurse Practitioner | 363LP2300X | 7847331-8900 | UT |
Addresses
Primary practice location
1055 N 500 W W
Building a
Provo, UT 84604
Mailing address
1055 N 500 W
Attn Credentialing
Provo, UT 84604
Phone (801) 354-8225
Other practice location 1
750 W 800 N
Orem, UT 84057-3660
Phone (801) 714-6080
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1055 N 500
Provo, UT 84604-3305
Phone (801) 812-5033
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7847331-4405 | UT | MD | Family Nurse Practitioner |
| 7847331-8900 | UT | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current | Accepting new patients | |
| Revere Health PC | Current | Accepting new patients |
Locations
750 W 800 N
Orem, UT 84057
Phone (801) 714-6000
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
1055 N 500 W
Bldg A
Provo, UT 84604
Phone (801) 418-0800
Interoperability endpoints
- ericlang@cuccu.allscriptsdirect.net
Organizations & group practices 2
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": "1756080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765152000000",
"number": "1649158981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"address_2": "ATTN CREDENTIALING",
"city": "PROVO",
"state": "UT",
"postal_code": "84604",
"telephone_number": "801-354-8225",
"fax_number": "801-418-0941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N 500 W W",
"address_2": "BUILDING A",
"city": "PROVO",
"state": "UT",
"postal_code": "84604",
"telephone_number": "801-812-5033",
"fax_number": "801-812-5034"
}
],
"practiceLocations": [
{
"address_1": "750 W 800 N",
"address_purpose": "LOCATION",
"city": "Orem",
"state": "UT",
"postal_code": "840573660",
"country_code": "US",
"telephone_number": "801-714-6080",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LANG",
"first_name": "ERIC",
"middle_name": "RAYMOND",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-25",
"last_updated": "2025-12-08",
"certification_date": "2025-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "UT",
"license": "7847331-4405",
"primary": true
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "UT",
"license": "7847331-8900",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.
- 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.