LU ANN JACOBS-PETERSON (APRN FNP) – Nurse Practitioner, NPI 1396918462
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for LU ANN JACOBS-PETERSON (APRN FNP)
Harris Village Clinic
251 N 1st St
Tooele, UT 84074
Phone: (435) 228-5151
Type: Location
Revere Health, 1055, North 500 West, North Park, Provo, Utah County, Utah, 84604, United States
CREDENTIALING DEPARTMENT
PROVO, UT 846043305
Phone: (801) 429-8000
Fax: (801) 429-8150
Type: Mailing
2376 N 400 E STE 205
TOOELE, UT 840743413
Phone: (435) 882-8111
Fax: (435) 882-2111
Type: Location
861 N 980 W
OREM, UT 840577710
Phone: (385) 262-4135
Fax: (801) 899-7996
Type: Location
14540 S MAJESTIC OAKS LN
HERRIMAN, UT 840963645
Phone: (801) 232-1998
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $129.
Total Amount is formed as General ($129) + Research ($0) + Ownership ($0) = $129.
Last reported payment date: 2024-04-26 • Largest payer in this snapshot: ABBVIE INC. ($65).
Total Amount
$129
General + Research + Ownership
Payments
5
Total payment records
General Amount
$129
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $65 |
| Exeltis, USA Inc. | $29 |
| Braintree Laboratories, Inc. | $18 |
| Solventum Corporation | $16 |
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: 2008-12-26
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20081226000049 | I | Nurse Practitioner | UT | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 15 | 15 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 13 | 11 | $0 |
Insurance plans in this area (ZIP 84074)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.