Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samantha Lee Stacks, NP

Individual provider Nurse Practitioner · NPI 1992261077

Samantha Lee Stacks, NP is a Nurse Practitioner in Salt Lake City, Utah. Qualified in 2018, 8 years ago. Practices with University of Utah Community Physicians Group, a 280-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
8
Licensed in
UT
In the registry since
2019
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

409 W 400 S
Salt Lake City, UT 84101-1135
Phone: (801) 364-0058
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10932001-4405 (UT)
Nurse Practitioner Taxonomy 363L00000X · Licence 10932001-4405 (UT)

Record details

NPI number1992261077
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedFebruary 14, 2019
Last updated in NPPESDecember 10, 2024
Certification dateDecember 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice University Of Utah Community Physicians Group — 280 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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