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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: August 09, 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
Phone(801) 507-4000
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
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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

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.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.

KRISTY BENTLEY DNP
Nurse Practitioner
5171 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-9800
DR. TODD JUSTIN ROBINSON D.O.
Surgery
5171 S COTTONWOOD ST
SALT LAKE CITY, UT 84107
Salt Lake County (801) 507-9600
JUN LIN FNP-C
Nurse Practitioner
5171 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-9310
STARLENE ROSE NP
Nurse Practitioner
5171 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-9310
LIANE C EMMETT APRN
Nurse Practitioner
5171 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-9310
ALEXIS ANN GASHLER NP
Nurse Practitioner
5171 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (801) 507-4000
SARA GRACEFFO CGC
Genetic Counselor, MS
5171 S COTTONWOOD ST
MURRAY, UT 84107
Salt Lake County (804) 507-4000
JONATHAN JAMES GOCHNOUR DO
Emergency Medicine
5171 S COTTONWOOD ST, SUITE 740
MURRAY, UT 84107
Salt Lake County (801) 507-9700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Archibald's NPI number?

The NPI number for Lisa Archibald is 1770053167. It was assigned to this individual provider in the NPPES registry on November 28, 2018. The provider is also known as Lisa Ann Ladle Pa-C.

Where is Lisa Archibald located?

Lisa Archibald practices at 5171 S Cottonwood St, Murray, UT 84107. The listed phone number is (801) 507-4000.

What is Lisa Archibald's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Lisa Archibald enrolled in Medicare?

Yes. Lisa Archibald is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lisa Archibald accept?

Health plans from Select Health list Lisa Archibald as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Lisa Archibald affiliated with any hospitals?

According to CMS data, Lisa Archibald is affiliated with Intermountain Medical Center.

When was this NPI record last updated?

The NPPES record for Lisa Archibald was last updated on April 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.