Individual provider Active NPI

Lance Owens, MD

  • Emergency Medicine Physician
  • Tooele, UT
National Provider Identifier
1972565471
Registry record updated May 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
183026-1205 Issued in UT
Practice address
2055 N Main St
Tooele, UT 84074-9819
Phone
(435) 843-3600
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 183026-1205 UT
Emergency Medicine Physician 207P00000X 183026-1205 UT Primary

Addresses

Primary practice location

2055 N Main St
Tooele, UT 84074-9819

Mailing address

144 S 500 E
2ND Floor
Salt Lake City, UT 84102-1907

Other identifiers 1

IdentifierTypeStateIssuer
10161MedicaidUT

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
I20050121000302 UT Practitioner - Emergency Medicine 0244144285 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
183026-1205UTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince Nov 1, 2004 Accepting new patients

Locations

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

2500 S State St
South Salt Lake, UT 84115
Phone (385) 646-5000

2055 N Main St
Tooele, UT 84074
Phone (435) 843-3600

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.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272931200000",
    "number": "1972565471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 S 500 E",
            "address_2": "2ND FLOOR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840749819",
            "telephone_number": "435-843-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "LANCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2010-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "183026-1205",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "183026-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10161",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tooele, UT

Sources for this page

Verify at the official NPI Registry.