NPIMap

Individual provider Active NPI

Laura L Vivio-Karle, PA-C

  • Physician Assistant
  • Iron Mountain, MI
National Provider Identifier
1063700854
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006404 Issued in MI
Practice address
1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone
(906) 774-1313
Fax
(906) 776-5639
NPI assigned
Jul 14, 2011
Last updated
Oct 22, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2764-23 WI
Physician Assistant 363A00000X 5601006404 MI Primary

Addresses

Primary practice location

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637

Mailing address

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone (906) 774-1313

Other identifiers 2

IdentifierTypeStateIssuer
1063700854MedicaidWI
5220026OtherMIBCBS MI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120925000774 MI Practitioner - Physician Assistant 5496924599 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1711 S Stephenson Ave
Iron Mountain, MI 49801-3648

1721 S Stephenson Ave
Iron Mountain, MI 49801-3637
Phone (906) 774-1313

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601006404MIMDPhysician Assistant
2764-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Jun 10, 2019 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Jun 10, 2019 Accepting new patients
Dickinson County Healthcare System CurrentSince May 14, 2023 Accepting new patients
Froedtert South, Inc. PastSince Jul 5, 2011 Accepting new patients

Locations

1711 S Stephenson Ave
Ste 315
Iron Mountain, MI 49801
Phone (906) 774-6257

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

417 Washington Ave
Iron River, MI 49935
Phone (906) 265-9908

Interoperability endpoints

  • Direct secure messaging: laura.vivio-karle.1@22710.direct.athenahealth.com
  • Direct secure messaging: laura.vivio-karle@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 7

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1063700854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 S STEPHENSON AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013637",
            "telephone_number": "906-774-1313",
            "fax_number": "906-776-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 S STEPHENSON AVE",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013637",
            "telephone_number": "906-774-1313",
            "fax_number": "906-776-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVIO-KARLE",
        "first_name": "LAURA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2764-23",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063700854",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "5220026",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.