Lisa Western (NPI# 1558712414, PAC ID# 2062700396) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1558712414 |
| PAC ID by PECOS | 2062700396 |
| Professional Enrollment ID | I20161019001150 |
| Full Name | Lisa Western |
| Organization Legal Name | MOUNTAINSTAR MEDICAL GROUP-ST. MARKS HOSPITAL LLC |
| Address |
4465 S 900 E Suite 200 Salt Lake City UT 84124-2456 |
| Phone Number | 8012662777 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1557443322 |
| Number of Group Practice Members | 21 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460047 | ST MARK'S HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 | 8012662777 | MOUNTAINSTAR MEDICAL GROUP-ST. MARKS HOSPITAL LLC |
| Organization Legal Name | MOUNTAINSTAR MEDICAL GROUP-ST. MARKS HOSPITAL LLC |
| Physicians | 21 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Todd W. Furness | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 11760 S 700 E, Suite 111, Draper, UT 84020-6605 |
| Todd N Schauers | Physician Assistant | Mountainstar Medical Group-st. Marks Hospital LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Philip Leonard Roberts | Internal Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Suite 300, Draper, UT 84020-5009 |
| Daniel Trevor Young | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Suite 300, Draper, UT 84020-5009 |
| David B Jack | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Draper, UT 84020-5009 |
| Amelia Maass | Nurse Practitioner | Mountainstar Medical Group-st. Marks Hospital LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Andrew Robinson | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Draper, UT 84020-5009 |
| Matthew M Schellenberg | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Draper, UT 84020-5009 |
| Richard Wayne Bennett | Internal Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 74 E Kimballs Ln, Draper, UT 84020-5009 |
| Joni W Hougaard | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Street Address |
4465 S 900 E SUITE 200 |
| City | SALT LAKE CITY |
| State | UT |
| Zip | 84124-2456 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Todd N Schauers | Physician Assistant | Mountainstar Medical Group-st. Marks Hospital LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Amelia Maass | Nurse Practitioner | Mountainstar Medical Group-st. Marks Hospital LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Joni W Hougaard | Family Medicine | Mountainstar Medical Group-st. Marks Hospital LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Shaun T Gundersen | Nurse Practitioner | Mountainstar Medical Group-st. Marks Hospital LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Barbara E Smith-holmen | Nurse Practitioner | Mountainstar Medical Group-st. Marks Hospital, LLC | 4465 S 900 E, Suite 200, Salt Lake City, UT 84124-2456 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Melisa S Steele | Nurse Practitioner | Granger Medical Clinic Inc | 1121 E 3900, Suite C130 Millcreek, Salt Lake City, UT 84124-1200 |
| Jan B Bernhisel-broadbent | Allergy/immunology | Granger Medical Clinic Inc | 1121 E 3900, Suite C130 Millcreek, Salt Lake City, UT 84124-1200 |
| Nathan Grant Adams | Maxillofacial Surgery | Oral and Facial Reconstructive Surgeons of Utah LLC | 3920 S 1100, Suite 150, Salt Lake City, UT 84124-1213 |
| Michael A Gladwell | Maxillofacial Surgery | Oral and Facial Reconstructive Surgeons of Utah LLC | 3920 S 1100, Suite 150, Salt Lake City, UT 84124-1213 |
| Sarah Elaine Kaihau | Nurse Practitioner | Valley Mental Health Incorporated | 1141 E 3900 S, A220, Salt Lake City, UT 84124-1215 |
| Timothy Champlin | Clinical Social Worker | Valley Mental Health Incorporated | 1141 E 3900 S, A220, Salt Lake City, UT 84124-1215 |
| Mina Gohari | Family Medicine | St Marks Physician Billing LLC | 1160 E 3900 S, G200, Salt Lake City, UT 84124-1224 |
| Cynthia J Lawlor | Family Medicine | St Marks Physician Billing LLC | 1160 E 3900 S, G200, Salt Lake City, UT 84124-1224 |
| Rebecca H Moore | Nephrology | St Marks Physician Billing LLC | 1160 E 3900 S, G200, Salt Lake City, UT 84124-1224 |
| Danesh Rahimi | Internal Medicine | St Marks Physician Billing LLC | 1160 E 3900 S, G200, Salt Lake City, UT 84124-1224 |
| Find all physicians in zip 84124 | |||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | SALT LAKE CITY + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Lisa Western.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.