Individual provider Active NPI

Laura M. Sulecki, NP

  • Pediatric Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1063726982
Registry record updated Feb 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
71001308 Issued in IN
Practice address
705 Riley Hospital Dr
Ri 1601
Indianapolis, IN 46202-5109
Phone
(317) 944-4846
Fax
(317) 948-0126
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 28131573 IN
Pediatric Nurse Practitioner 363LP0200X 71001308 IN Primary

Addresses

Primary practice location

705 Riley Hospital Dr
Ri 1601
Indianapolis, IN 46202-5109

Mailing address

PO Box 1026
Indianapolis, IN 46206-1026
Phone (317) 274-1201

Other identifiers 1

IdentifierTypeStateIssuer
200993780MedicaidIN

Other names 1

  • Laura Liepnieks Former name

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28131573INMDPediatric Nurse Practitioner
71001308INMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatric Associates, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298851200000",
    "number": "1063726982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1026",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061026",
            "telephone_number": "317-274-1201",
            "fax_number": "317-278-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 RILEY HOSPITAL DR",
            "address_2": "RI 1601",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025109",
            "telephone_number": "317-944-4846",
            "fax_number": "317-948-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULECKI",
        "first_name": "LAURA",
        "middle_name": "M.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2011-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "28131573",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71001308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200993780",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "LIEPNIEKS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; 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.