Individual provider Active NPI

Debra Crider Lawrence, DPM

  • Podiatrist
  • Westerly, RI
National Provider Identifier
1073547162
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DPM00233 Issued in RI
Practice address
85 Beach Street
BLDG C
Westerly, RI 02891
Phone
(401) 596-0823
Fax
(401) 596-2960
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DPM00233 RI Primary
Podiatrist 213E00000X 000453 CT

Addresses

Primary practice location

85 Beach Street
BLDG C
Westerly, RI 02891

Mailing address

85 Beach Street
BLDG C
Westerly, RI 02891
Phone (401) 596-0823

Other identifiers 3

IdentifierTypeStateIssuer
030880OtherRIHEALTH NET
030880OtherCTHEATH NET
030000233RID1OtherRIANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110509000335 CT Practitioner - Podiatry 4880870880 Practice locations: East Lyme, CT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000453CTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1073547162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 BEACH STREET",
            "address_2": "BLDG C",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "02891",
            "telephone_number": "401-596-0823",
            "fax_number": "401-596-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BEACH STREET",
            "address_2": "BLDG C",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "02891",
            "telephone_number": "401-596-0823",
            "fax_number": "401-596-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "DEBRA",
        "middle_name": "CRIDER",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "DPM00233",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "000453",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "030880",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEATH NET",
            "identifier": "030880",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "030000233RID1",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerly, RI

Sources for this page

Verify at the official NPI Registry.