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

Spencer Lee Lake

Individual provider Family Nurse Practitioner · NPI 1932869377

Spencer Lee Lake is a Nurse Practitioner in Bountiful, Utah. Qualified in 2021, 5 years ago. Practices with Joshua Oaks MD PLLC, a 31-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
5
Licensed in
UT
In the registry since
2021
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Practice location Address checks out

557 W 2600 S
Bountiful, UT 84010-7717
Phone: (801) 298-9155
Fax: (801) 298-9156
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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 6342236-4405 (UT)

Record details

NPI number1932869377
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 27, 2021
Last updated in NPPESDecember 27, 2021
Certification dateDecember 27, 2021
Mailing address557 W 2600 S, Bountiful, UT 84010-7717

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Joshua Oaks Md Pllc — 31 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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