Individual provider Active NPI

Lauryn Vacek

  • Intellectual Disabilities Intermediate Care Facility
  • Papillion, NE
National Provider Identifier
1073322467
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
H13972224 Issued in NE
Practice address
539 E 5TH St
Papillion, NE 68046-2208
Phone
(719) 251-6935
NPI assigned
Dec 31, 2024
Last updated
Dec 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X H13972224 NE Primary

Addresses

Primary practice location

539 E 5TH St
Papillion, NE 68046-2208

Mailing address

8006 S 68TH Street Cir
La Vista, NE 68128-4365
Phone (402) 885-3164

Other identifiers 1

IdentifierTypeStateIssuer
41305264OtherNEINDEPENDENT PROVIDER

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

State licenses

LicenseStateTypeSpecialty
H13972224NEMDIntellectual Disabilities Intermediate Care Facility

NPI Registry JSON

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

{
    "created_epoch": "1735603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1073322467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8006 S 68TH STREET CIR",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681284365",
            "telephone_number": "402-885-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 E 5TH ST",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680462208",
            "telephone_number": "719-251-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACEK",
        "first_name": "LAURYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-31",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NE",
            "license": "H13972224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT PROVIDER",
            "identifier": "41305264",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.