LYNN MARIE MCMILLAN (NP-BC) – Nurse Practitioner, NPI 1053457085

LYNN MARIE MCMILLAN (NP-BC) is a healthcare provider. based in Midvale, Utah. specializing in Nurse Practitioner. They hold the professional credentials NP-BC. They hold a License No. 268113-4405 (UT). The NPI Number for LYNN MARIE MCMILLAN (NP-BC) is 1053457085

Main info

Female
28 Years Of Experience
Accepts Medicare Assignment
Name
LYNN MARIE MCMILLAN (NP-BC)
NPI
1053457085
Phone
(801) 233-4400
Address
1225 FORT UNION BLVD
Enumeration Date
29 January 2007
Last Update Date
4 March 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1998 (28 years ago)
PAC ID
5092700641
Group Practice PAC ID
1850209420
Professional Enrollment ID
I20040414002009
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for LYNN MARIE MCMILLAN (NP-BC)

  • Fort Union Boulevard, Essex Court Condo, Midvale, Salt Lake County, Utah, 84127, United States

    SUITE 200

    MIDVALE, UT 840471889

    Phone: (801) 233-4400

    Type: Location

  • PO BOX 27128

    SALT LAKE CITY, UT 841270128

    Phone: (801) 442-4950

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-04-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040414002009INurse PractitionerUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes2721$0
View full utilization report →

Insurance plans in this area (ZIP 84047)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1850209420View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm LYNN MARIE MCMILLAN (NP-BC)'s NPI?
Yes. LYNN MARIE MCMILLAN (NP-BC) is listed with NPI 1053457085 in the public NPI dataset.
Can I rely on LYNN MARIE MCMILLAN (NP-BC) being an active provider?
As of the registry snapshot, LYNN MARIE MCMILLAN (NP-BC) is marked active.
What healthcare role does LYNN MARIE MCMILLAN (NP-BC) hold?
Scheduling teams often label LYNN MARIE MCMILLAN (NP-BC) under Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does LYNN MARIE MCMILLAN (NP-BC) list a practice location?
Patients near Midvale, Utah may find LYNN MARIE MCMILLAN (NP-BC) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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