Judith A Lauridsen, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN09057 Issued in MT

Practice address

210 Riverside Drive
Poplar, MT 59255

Phone

(406) 768-5171

Fax

(406) 768-6161

NPI assigned

Aug 17, 2006

Last updated

Feb 8, 2008By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/ac22fd4c-796d-4bb8-9292-da1e40231549/

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.

• Northeast Montana Health Services Inc

  dba Faith Lutheran Home

  • Critical Access Hospital
  • Wolf Point, MT
  • NPI 1821016536
  Medicare reassignment NPD
• Northeast Montana Health Services, Inc.

  dba Poplar Community CAH

  • Critical Access Hospital
  • Poplar, MT
  • NPI 1396766903
  Medicare reassignment NPD
• Riverside Family Clinic

  • Rural Health Clinic/Center
  • Poplar, MT
  • NPI 1255351862
  Medicare reassignment NPD
• Wolf Point Clinic Association Inc

  dba Listeruds Rural Health Clinic

  • Rural Health Clinic/Center
  • Wolf Point, MT
  • NPI 1992722904
  Medicare reassignment NPD
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202428800000",
    "number": "1124132378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 RIVERSIDE DRIVE",
            "address_2": "PO BOX 629",
            "city": "POPLAR",
            "state": "MT",
            "postal_code": "59255",
            "telephone_number": "406-768-5171",
            "fax_number": "406-768-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 RIVERSIDE DRIVE",
            "city": "POPLAR",
            "state": "MT",
            "postal_code": "59255",
            "telephone_number": "406-768-5171",
            "fax_number": "406-768-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURIDSEN",
        "first_name": "JUDITH",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2008-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "RN09057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0433238",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6827120",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Michael Korkowski, MLT (ASCP)
• Mark Wray Korman
• Lila E Kukowski, MT
• Ray R Laboy Espada, M.D.
• Lindsay Land, RN
• Olivia Lorentz
• Holly Macfarlane
• Carrie L Manning
• Petrea Mary Martin, LCPC
• Sarah Marie Martin

• Nurse Practitioner in Poplar, MT
• Providers in Poplar, MT by specialty
• Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2008; 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.