Lori E Sieboldt, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01059205A Issued in IN

Practice address

600 Mary St
Evansville, IN 47747-0001

Phone

(812) 450-3405

Fax

(812) 450-3099

NPI assigned

Oct 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• Lori S Lowery Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Deaconess Clinic Inc

  • Pediatrics Physician
  • Washington, IN
  • NPI 1356132310
  NPD
• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585
  NPD
• Deaconess Clinic, Inc

  • Family Medicine Physician
  • Newburgh, IN
  • NPI 1114284577
  NPD
• Emergency Medicine Physicians of Cuyahoga County, LTD

  • Emergency Medicine Physician
  • Akron, OH
  • NPI 1265471148
  NPD (past)
• Emergency Medicine Physicians of Medina County, LTD

  • Emergency Medicine Physician
  • Lodi, OH
  • NPI 1457390312
  NPD (past)
• Emergency Medicine Physicians of Stark County, LTD

  • Emergency Medicine Physician
  • Massillon, OH
  • NPI 1902846371
  NPD (past)
• Vail Clinic, Inc.

  • Specialist
  • Keystone, CO
  • NPI 1386725406
  NPD (past)
• VVMC Diversified Services

  • Specialist
  • Edwards, CO
  • NPI 1730279712
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1053409623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3407",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477333407",
            "telephone_number": "812-450-3405",
            "fax_number": "812-450-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477470001",
            "telephone_number": "812-450-3405",
            "fax_number": "812-450-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBOLDT",
        "first_name": "LORI",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01059205A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - GATEWAY",
            "identifier": "000000381085",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAMP PIN",
            "identifier": "097292",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7197383",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - MARY STREET",
            "identifier": "000000333639",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200494470",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PIN",
            "identifier": "2244686",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64082910",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK PIN",
            "identifier": "681577",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "LOWERY",
            "middle_name": "S",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sicc Services LLC
• Amy Siddens Land, MSW, LCSW
• Adeel Mohammad Siddiqui, M.D.
• Mayme Siders, LCSW
• Ryan A Sidney
• Brandy Sievers, BSN, RN
• Payton Sievers
• Erin Sigler, NP-C
• Signature School, Inc.
• Courtney Silke, D.C.

• Emergency Medicine Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.