Individual provider Active NPI

Leeann Johnson, FNP

  • Nurse Practitioner
  • West Valley City, UT
National Provider Identifier
1942462825
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
295486-4405 Issued in UT
Practice address
2965 W 3500 S
West Valley City, UT 84119-3602
Phone
(801) 965-3600
NPI assigned
Jul 1, 2008
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 295486-4405 UT Primary
Family Nurse Practitioner 363LF0000X 295486-4405 UT

Addresses

Primary practice location

2965 W 3500 S
West Valley City, UT 84119-3602

Mailing address

2965 W 3500 S
West Valley City, UT 84119-3602
Phone (801) 965-3600

Other identifiers 2

IdentifierTypeStateIssuer
1164672770MedicaidUT
295486-4408OtherUTLICENSE

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
I20081209000489 UT Practitioner - Nurse Practitioner 5294896262 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Practice addresses (Care Compare)

2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
295486-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountainstar Medical Group-St. Marks Hospital, LLC CurrentSince Jan 1, 2012 Accepting new patients
Granger Medical Clinic PC CurrentSince Dec 1, 2025 Accepting new patients
Granger Medical Clinic PC Current Accepting new patients
Granger Medical Specialists LLC CurrentSince Dec 1, 2025 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Dec 1, 2025 Accepting new patients
Granger Medical Clinic PC CurrentSince Dec 1, 2025 Accepting new patients
Jordan Family Health, LLC Past Accepting new patients

Locations

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

995 W Levoy Dr
Taylorsville, UT 84123

8846 S Redwood Rd
Ste E12
West Jordan, UT 84088
Phone (801) 266-2777

8846 S Redwood Rd
Ste E121
West Jordan, UT 84088
Phone (801) 268-4141

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1942462825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LEEANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "295486-4405",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "295486-4405",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164672770",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "295486-4408",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

Verify at the official NPI Registry.