Individual provider Active NPI

Lance Charles Delange, FNP

  • Nurse Practitioner
  • Logan, UT
National Provider Identifier
1861476939
Registry record updated Jun 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3265324405 Issued in UT
Practice address
2310 N 400 E
Ste a
Logan, UT 84341-1788
Phone
(435) 787-2000
Fax
(435) 787-1913
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3265324405 UT Primary

Addresses

Primary practice location

2310 N 400 E
Ste a
Logan, UT 84341-1788

Mailing address

2310 N 400 E
Ste a
Logan, UT 84341-1788
Phone (435) 787-2000

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031122000074 UT Practitioner - Nurse Practitioner 1850295601 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Utah School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpine Management and ConsultingGroup PAC ID 5496659245, 21 clinicians

Practice addresses (Care Compare)

2310 N 400
Suite a
North Logan, UT 84341-1796
Phone (435) 787-2000

64 N 1St
Suite 201
Preston, ID 83263-1326
Phone (208) 852-1295

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Management and Consulting CurrentSince Jul 27, 2001 Accepting new patients

Locations

64 N 1st E
Ste 201
Preston, ID 83263
Phone (208) 852-1295

44 N 1st E
Preston, ID 83263
Phone (208) 852-0137

1030 S Medical Dr
Ste A
Brigham City, UT 84302
Phone (435) 723-4500

55 E Golf Course Rd
Logan, UT 84321
Phone (435) 760-3734

55 E Golf Course Rd
Unit B
Logan, UT 84321

1219 N 400 E
North Logan, UT 84341
Phone (435) 565-6043

2310 N 400 E
Ste A
North Logan, UT 84341
Phone (435) 774-8547

Interoperability endpoints

  • Direct secure messaging: ldelange@alpineortho.emadirect.md

Organizations & group practices 1

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.

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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1861476939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 N 400 E",
            "address_2": "STE A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411788",
            "telephone_number": "435-787-2000",
            "fax_number": "435-787-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 N 400 E",
            "address_2": "STE A",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411788",
            "telephone_number": "435-787-2000",
            "fax_number": "435-787-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELANGE",
        "first_name": "LANCE",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "3265324405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.