LISA LADLE ARCHIBALD PA-C
NPI 1770053167
Physician Assistant in Murray, UT

Active since November 28, 2018PECOS EnrolledAccepts Medicare Assignment
5171 S COTTONWOOD ST, MURRAY, UT 84107(801) 507-4000 Get Directions Write a Review

NPPES record last updated: April 8, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 8, 2026, Feb 14, 2019, Feb 8, 2019 and 2 more (5 updates tracked since 2018).

About Lisa Ladle Archibald Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA LADLE ARCHIBALD PA-C (NPI 1770053167) is an individual physician assistant in Murray, Utah, licensed in Utah (8496933-1206) and active in the NPI registry since November 2018. She is enrolled in Medicare PECOS, is affiliated with Intermountain Medical Center, and maintains a secondary practice location in Draper.

NPPES Registry Identity

NPI1770053167
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameLISA LADLE ARCHIBALDCredential: PA-C
Location Address5171 S COTTONWOOD STMurray, UT 84107-5704
Mailing AddressPo Box 27128Salt Lake City, UT 84127-0128
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateNovember 28, 2018
Last NPPES UpdateApril 8, 20265 updates tracked since enumeration
NPPES CertifiedApril 8, 2026
NPI 1770053167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in UT · 8496933-1206
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

5171 S COTTONWOOD ST, Murray, UT 84107

Other Names 1

Former Name (1)Lisa Ann Ladle Pa-c

Secondary Practice Location 1

Location 174 E Kimballs Ln Ste 300Draper, UT 84020-5009 · Phone (801) 572-0311

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Lisa Ladle Archibald Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5092057018
PECOS Enrollment IDI20190423001747
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Intermountain Medical Center

Acute Care Hospitals · Murray, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460010
Location5121 South Cottonwood StreetMurray, UT 84107 · Salt Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Emergency Medicine
5171 S COTTONWOOD ST, STE 740
MURRAY, UT 84107
Registered Nurse
5171 S COTTONWOOD ST, SUITE 220
MURRAY, UT 84107
Physical Therapist
5171 S COTTONWOOD ST, SUITE 810
MURRAY, UT 84107
Urology
5171 S COTTONWOOD ST, STE 720
MURRAY, UT 84107
Internal Medicine (Cardiovascular Disease)
5171 S COTTONWOOD ST, STE 350
MURRAY, UT 84107
Emergency Medicine
5171 S COTTONWOOD ST, STE 740
MURRAY, UT 84107
Nurse Practitioner
5171 S COTTONWOOD ST, SUITE 740
MURRAY, UT 84107
Surgery
5171 S COTTONWOOD ST, STE 650
MURRAY, UT 84107

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770053167, enumerated as an "individual" on November 28, 2018.

The provider is located at 5171 S COTTONWOOD ST MURRAY, UT 84107 and the phone number is (801) 507-4000.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Select Health. Please consult your insurance carrier or call the provider to verify.

Lisa Archibald is affiliated with: INTERMOUNTAIN MEDICAL CENTER.