MR. JOHN WALKER LELIS PA-C NPI 1275812208

NPI Information

NPI: 1275812208
Provider Name: MR. JOHN WALKER LELIS, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: INTERMOUNTAIN HEALTHCARE SERVICES, INC

PECOS Registration: Yes

Address:
5121 S COTTONWOOD ST
MURRAY, UT
ZIP 84107
Phone: (801) 507-4017
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MR. John Walker Lelis, PA-C is a medical physician assistant in Murray, UT with 13 years of experience. MR. John Walker Lelis, PA-C NPI is 1275812208. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5121 S COTTONWOOD ST
MURRAY, UT
ZIP 84107-701
Phone: (801) 507-4017
Fax: (801) 507-4809

The NPI 1275812208 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/9/2011 and was last updated on 4/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	8516577-1206	UTAH	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1275812208	MEDICAID	UTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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