Stacey Lake, NP
Stacey Lake, NP is a Primary Care Nurse Practitioner in Holladay, UT, registered under NPI 1154003473. This provider registers 3 separate taxonomy codes, which usually means they practise across more than one recognised specialty.
Getting there
The practice address on file is 999 E MURRAY HOLLADAY RD STE 207, Holladay, UT 84117. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 5641317-4405 | UT | Family Nurse Practitioner |
| 5641317-4405 | UT | Nurse Practitioner |
| 5641317-4405 | UT | Primary Care Nurse Practitioner primary |
This provider holds licence 5641317-4405 issued in UT. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Nurse Practitioner
- PAC ID
- 0749643039
- Enrollment ID
- I20230905001693
Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Primary Care covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363LP2300X
All registered taxonomy codes
This provider registers 3 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 363LF0000X | Family Nurse Practitioner Family | 5641317-4405 | UT | |
| 363L00000X | Nurse Practitioner | 5641317-4405 | UT | |
| 363LP2300X | Primary Care Nurse Practitioner Primary Care | 5641317-4405 | UT | primary |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1154003473 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Aug 4, 2023 |
| Last updated | Jan 22, 2025 |
| Status | Active |
| Sole proprietor | No |
| Gender | Female |
| Credential | NP |
| Practice address |
999 E MURRAY HOLLADAY RD STE 207 Holladay, UT 84117 (801) 268-2584 |
| Mailing address |
2965 W 3500 S West Valley City, UT 84119 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 1 | 5 | 4 | 0 | 0 | 3 | 4 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 1 | 1 | 4 | 0 | 0 | 6 | 4 | 5 |
Sum = 47 · next multiple of 10 = 50 · check digit = 3 · actual last digit = 3
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.