Lars Ulissey

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A81520 Issued in CA

Practice address

7321 11TH St
BLDG 569
Hill AFB, UT 84056-5012

Phone

(801) 777-4710

NPI assigned

Oct 17, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1821087420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5914 HIGHLAND DR",
            "city": "MORGAN",
            "state": "UT",
            "postal_code": "840509758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7321 11TH ST",
            "address_2": "BLDG 569",
            "city": "HILL AFB",
            "state": "UT",
            "postal_code": "840565012",
            "telephone_number": "801-777-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULISSEY",
        "first_name": "LARS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A81520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dave H. Thacker, M.D.
• The Janz Corporation (Janz Medical Supply)
• Erin Sutphen Thompson, PHARM. D.
• Jessica Lynn Townsend, ATC
• Gregory Turnbow, LCSW
• Carter Ulrich, DDS
• Kimberly Vansweden
• Katie Villarreal
• Leeann Washatka, LCSW
• Katherine Washington, NP

• General Practice Physician in Hill AFB, UT
• Providers in Hill AFB, UT by specialty
• General Practice Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.