Lacey A Cooper, NP-C in Salt Lake City, UT - Medicare Nurse Practitioner

Lacey A Cooper, NP-C is a medicare enrolled "Nurse Practitioner - Adult Health" in Salt Lake City, Utah. She graduated from nursing school in 2020 and has 4 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Mmg Llc and her current practice location is 50 N Medical Dr, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (702) 281-8904.

Lacey A Cooper is licensed to practice in Utah (license number 9043708-4409) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1639796477.

Contact Information

	Lacey A Cooper, NP-C
	50 N Medical Dr, Salt Lake City, UT 84132-0001
	(702) 281-8904
	Not Available

Map and Direction

Provider's Profile

Full Name	Lacey A Cooper
Gender	Female
Speciality	Nurse Practitioner
Experience	4 Years
Location	50 N Medical Dr, Salt Lake City, Utah
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Lacey A Cooper graduated from nursing school in 2020

NPI Data:

NPI Number: 1639796477
Provider Enumeration Date: 06/27/2020
Last Update Date: 11/12/2021

Medicare PECOS Information:

PECOS PAC ID: 5294152047
Enrollment ID: I20200825003685

Medical Identifiers

Medical identifiers for Lacey A Cooper such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639796477	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2200X	Nurse Practitioner - Adult Health	9043708-4409 (Utah)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Canyon Home Care	Salt lake city, UT	Home health agency
Active Home Health	Sandy, UT	Home health agency
Rocky Mountain Home Care	Layton, UT	Home health agency
Harmony Home Health	Murray, UT	Home health agency
Canyon Hospice	Salt lake city, UT	Hospice
Active Hospice, Llc	Sandy, UT	Hospice
Harmony Hospice	Murray, UT	Hospice
Mountain West Medical Center	Tooele, UT	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Mmg Llc	5991039489	10

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lacey A Cooper allows following entities to bill medicare on her behalf.

Entity Name	Tooele Clinic Corp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073512364 PECOS PAC ID: 6800700873 Enrollment ID: O20031113000800

Entity Name	University Of Utah Adult Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114321981 PECOS PAC ID: 0941525273 Enrollment ID: O20150209001683

Entity Name	Mmg Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295392645 PECOS PAC ID: 5991039489 Enrollment ID: O20190703001917

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lacey A Cooper is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Lacey A Cooper, NP-C 797 Welles Cannon Rd, Grantsville, UT 84029-5563 Ph: (702) 281-8904	Lacey A Cooper, NP-C 50 N Medical Dr, Salt Lake City, UT 84132-0001 Ph: (702) 281-8904

Reviews and Comments

Nurse Practitioner Nurses in Salt Lake City, UT

Mrs. Lisa Ann Runyon, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Trauma Services, Salt Lake City, UT 84113 Phone: 801-662-2993 Fax: 801-662-2999
Madeline Ann Thayer, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-3600
Emma Fong, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3802 S 700 E, Salt Lake City, UT 84106 Phone: 801-264-6000
Ashlee Brynn Fenton, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1160 E 3900 S Ste G200, Salt Lake City, UT 84124 Phone: 801-268-7766
Donna M. Wahoff-stice, APRN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 615 Arapeen Dr, 100, Salt Lake City, UT 84108 Phone: 801-581-7761
Linda M Lambert, A.P.R.N. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Salt Lake City, UT 84113 Phone: 801-662-1000
Ms. Ann A. K. Kamp, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 100 N Medical Dr, Salt Lake City, UT 84113 Phone: 801-662-1000 Fax: 801-662-4166

Lacey A Cooper, NP-C - Medicare Nurse Practitioner in Salt Lake City, UT