Venice Lucia Wilkes, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11159450-1206 Issued in UT

Practice address

412 N 200 E
Logan, UT 84321-4038

Phone

(435) 713-2710

NPI assigned

Jan 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Venice Lucia Lopez Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT, WY2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Logan Regional Hospital Hospital, Logan, UT, CCN 460015

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group
• Community Health Center of Central Wyoming, Inc.

  • Federally Qualified Health Center (FQHC)
  • Casper, WY
  • NPI 1447480561
  Medicare reassignment NPD (past)
• Glenrock Hospital District

  dba glenrock health center

  • Rural Health Clinic/Center
  • Glenrock, WY
  • NPI 1093758161
  Medicare reassignment
• Ihc Health Services Inc

  dba Alta View Plastic Surgery Specialists

  • Plastic Surgery Physician
  • Sandy, UT
  • NPI 1841543477
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Community Health Center of Central Wyoming Inc

  dba Community Health Center of Central Wyoming Inc Riverton

  • Federally Qualified Health Center (FQHC)
  • Riverton, WY
  • NPI 1275810160
  NPD
• Glenrock Hospital District

  dba glenrock health center

  • Clinical Medical Laboratory
  • Glenrock, WY
  • NPI 1437294972
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  dba Intermountain Health Logan Regional Hospital

  • General Acute Care Hospital
  • Logan, UT
  • NPI 1831108497
  Care Compare affiliation

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1821596073",
    "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",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 N 200 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214038",
            "telephone_number": "435-713-2710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W 800 N # 220",
            "address_purpose": "LOCATION",
            "city": "Orem",
            "state": "UT",
            "postal_code": "84057",
            "country_code": "US",
            "telephone_number": "385-203-1250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1175 E 50 S Ste 241",
            "address_purpose": "LOCATION",
            "city": "American Fork",
            "state": "UT",
            "postal_code": "840032849",
            "country_code": "US",
            "telephone_number": "801-812-5033",
            "fax_number": "801-812-5034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5000 Blackmore Rd",
            "address_purpose": "LOCATION",
            "city": "Casper",
            "state": "WY",
            "postal_code": "826093345",
            "country_code": "US",
            "telephone_number": "307-233-6000",
            "fax_number": "307-233-6089",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "925 W Birch St",
            "address_purpose": "LOCATION",
            "city": "Glenrock",
            "state": "WY",
            "postal_code": "826375079",
            "country_code": "US",
            "telephone_number": "307-436-9206",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N 500 W Bldg A",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043305",
            "country_code": "US",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKES",
        "first_name": "VENICE",
        "middle_name": "LUCIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "PT904",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9110986",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11159450-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC/ Office Ally",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "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": "VENICE",
            "last_name": "LOPEZ",
            "middle_name": "LUCIA",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Taylor Widdison
• Douglas Ray Wiese
• Hannah M. Wilcox, MD
• Jeremy Steven Wiley, ATC
• Kyle Andrew Wilkes, PA-C
• Devin L Wilkey, OTD, OTR/L
• Michael S Wilkinson, DMD, MD
• Rachel G. Wilkinson, C.S.W
• Stuart D. Wilkinson, DDS
• Deven Willardson, BSN, RN

• Physician Assistant in Logan, UT
• Providers in Logan, UT by specialty
• Physician Assistant in Utah

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

Verify at the official NPI Registry.