Active NPI
Lisa Ladle Archibald, PA-C
- Physician Assistant
- Murray, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 8496933-1206
- Practice address
- 5171 S Cottonwood St
Murray, UT 84107-5704 - Phone
- (801) 507-4000
- NPI assigned
- Nov 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 8496933-1206 | UT | Primary |
Addresses
Primary practice location
5171 S Cottonwood St
Murray, UT 84107-5704
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
74 E Kimballs Ln Ste 300
Draper, UT 84020-5009
Phone (801) 572-0311
Other names 1
- Lisa Ann Ladle
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguestService | Other | Bluemark LLC / Office Ally |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190423001747 | UT | Practitioner - Physician Assistant | 5092057018 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ihc Health Services Inc
Practice addresses (Care Compare)
5121 S Cottonwood St
Murray, UT 84107-5701
5131 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-3888
8 TH Ave and C St
LDS Hosp Eeg Phys GRP
Salt Lake City, UT 84143
Phone (801) 507-7000
Hospital & facility affiliations
- Intermountain Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8496933-1206 | UT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080
5171 S Cottonwood St
South Salt Lake, UT 84107
Phone (801) 507-4000
1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479
Organizations & group practices 5
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.
-
- Hospitalist Physician
- Spanish Fork, UT
- NPI 1265036057
-
- Multi-Specialty Clinic/Center
- Logan, UT
- NPI 1760616528
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1770053167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5171 S COTTONWOOD ST",
"city": "MURRAY",
"state": "UT",
"postal_code": "841075704",
"telephone_number": "801-507-4000"
}
],
"practiceLocations": [
{
"address_1": "74 E Kimballs Ln Ste 300",
"address_purpose": "LOCATION",
"city": "Draper",
"state": "UT",
"postal_code": "840205009",
"country_code": "US",
"telephone_number": "801-572-0311",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ARCHIBALD",
"first_name": "LISA",
"middle_name": "LADLE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-28",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "8496933-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguestService",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.2019.3",
"affiliationName": "Bluemark LLC / Office Ally",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "1300 SE Cardinal Ct Ste 190",
"city": "Vancouver",
"state": "WA",
"country_code": "US",
"postal_code": "986839683",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "LISA",
"last_name": "LADLE",
"middle_name": "ANN",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
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 Apr 8, 2026; 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.