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

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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 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Mmg Stansbury Family Practice 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 NameLacey A Cooper
GenderFemale
SpecialityNurse Practitioner
Experience6 Years
Location50 N Medical Dr, Salt Lake City, Utah
Accepts Medicare AssignmentsYes. 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.
IdentifierTypeStateIssuer
1639796477NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2200XNurse Practitioner - Adult Health 9043708-4409 (Utah)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Canyon Home CareMurray, UTHome health agency
Harmony Home HealthMurray, UTHome health agency
Atlas Home CareLayton, UTHome health agency
Rocky Mountain Home Health - UtahWoods cross, UTHome health agency
Active Home HealthSandy, UTHome health agency
Mountain West Medical CenterTooele, UTHospital
St Luke's Regional Medical CenterBoise, IDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Mmg Stansbury Family Practice Llc79113714224

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 NameTooele Clinic Corp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073512364
PECOS PAC ID: 6800700873
Enrollment ID: O20031113000800
Entity NameUniversity of Utah Adult Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114321981
PECOS PAC ID: 0941525273
Enrollment ID: O20150209001683
Entity NameMmg Stansbury Family Practice LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1730892274
PECOS PAC ID: 7911371422
Enrollment ID: O20230324000780

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 AddressPractice 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


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Madeline Ann Thayer, NP
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Phone: 801-268-7766    
Ms. Sharon A Korhel, APRN
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Practice Location: 1105 W 1000 N, Salt Lake City, UT 84116
Phone: 801-408-8626    Fax: 801-364-2436

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.