Individual provider Active NPI

Lloyd Issac Neilsen, RN, BSN

  • Registered Nurse
  • Fort Duchesne, UT
National Provider Identifier
1831534361
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
193886-3102 Issued in UT
Practice address
6822 East 1000 South
Ft. Duchesne, UT 84026
Phone
(435) 725-6895
NPI assigned
May 10, 2013
Last updated
May 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 193886-3102 UT Primary

Addresses

Primary practice location

6822 East 1000 South
Ft. Duchesne, UT 84026

Mailing address

6822 East 1000 South
Ft. Duchesne, UT 84026
Phone (435) 725-6895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
193886-3102UTMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1831534361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6822 EAST 1000 SOUTH",
            "city": "FT. DUCHESNE",
            "state": "UT",
            "postal_code": "84026",
            "telephone_number": "435-725-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6822 EAST 1000 SOUTH",
            "city": "FT. DUCHESNE",
            "state": "UT",
            "postal_code": "84026",
            "telephone_number": "435-725-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILSEN",
        "first_name": "LLOYD",
        "middle_name": "ISSAC",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-10",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "193886-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Duchesne, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2013; 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.