Individual provider Active NPI

Lawrence K Beck, CRNA

  • Certified Registered Nurse Anesthetist
  • Janesville, WI
National Provider Identifier
1003872052
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
104-033 Issued in WI
Practice address
3400 E Racine St
Janesville, WI 53546-2344
Phone
(608) 373-8000
Fax
(608) 373-8148
NPI assigned
Apr 26, 2006
Last updated
Mar 14, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 104-033 WI Primary

Addresses

Primary practice location

3400 E Racine St
Janesville, WI 53546-2344

Mailing address

3400 E Racine St
Janesville, WI 53546-2344
Phone (608) 373-8000

Other practice location 1

3400 E Racine St
Janesville, WI 53546-2344
Phone (608) 373-8000

Other identifiers 1

IdentifierTypeStateIssuer
43306700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
104-033WIMDCertified Registered Nurse Anesthetist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1003872052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 E RACINE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462344",
            "telephone_number": "608-373-8000",
            "fax_number": "608-373-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 E RACINE ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535462344",
            "telephone_number": "608-373-8000",
            "fax_number": "608-373-8148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 E Racine St",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535462344",
            "country_code": "US",
            "telephone_number": "608-373-8000",
            "fax_number": "608-373-8280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BECK",
        "first_name": "LAWRENCE",
        "middle_name": "K",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "104-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43306700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.