Individual provider Active NPI

Parker Winfield Lemon, DO

  • Family Medicine Physician
  • Eagle Mountain, UT
National Provider Identifier
1902508674
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14277751-1204 Issued in UT
Practice address
4095 E Pony Express Pkwy Ste 1
Eagle Mountain, UT 84005-5531
Phone
(801) 429-8037
Fax
(801) 753-7476
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14277751-1204 UT Primary

Addresses

Primary practice location

4095 E Pony Express Pkwy Ste 1
Eagle Mountain, UT 84005-5531

Mailing address

1055 N 500 W
Provo, UT 84604-3305
Phone (801) 354-8225

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260622002545 UT Practitioner - Family Practice 9638537525

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1055 N 500
Provo, UT 84604-3305

Hospital & facility affiliations

  • Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
14277751-1204UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Jun 30, 2026 Accepting new patients
Revere Health PC PastSince Jun 30, 2026 Accepting new patients

Locations

4095 E Pony Express Pkwy
Ste 1
Eagle Mountain, UT 84005
Phone (801) 429-8037

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

Interoperability endpoints

  • Direct secure messaging: parker.lemon.1@16437.direct.athenahealth.com

Organizations & group practices 2

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": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1902508674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4095 E PONY EXPRESS PKWY STE 1",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055531",
            "telephone_number": "801-429-8037",
            "fax_number": "801-753-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMON",
        "first_name": "PARKER",
        "middle_name": "WINFIELD",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "14277751-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Mountain, UT

Sources for this page

Verify at the official NPI Registry.