Individual provider Active NPI

Lanette Rickborn, MD

  • Urology Physician
  • Augusta, GA
National Provider Identifier
1174985444
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
101113 Issued in GA
Practice address
1447 Harper Street Medical Office Building Suite 4G
Augusta, GA 30912-5703
Phone
(706) 721-3042
NPI assigned
Mar 24, 2016
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Urology Physician 208800000X 83316-20 WI
Urology Physician 208800000X 20791 NV
Urology Physician 208800000X 101113 GA Primary

Addresses

Primary practice location

1447 Harper Street Medical Office Building Suite 4G
Augusta, GA 30912-5703

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (800) 782-8581

Other practice location 1

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com
Direct Messaging Address lrickborn618380@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, GA, TN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20231213002419 WI Practitioner - Urology 0941590830 Reassigns benefits to 9 organizations
I20250221000653 GA Practitioner - Urology 0941590830 Reassigns benefits to 2 organizations
I20260220001604 TN Practitioner - Urology 0941590830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoebe Physician Group IncGroup PAC ID 8426112350, 420 clinicians

Practice addresses (Care Compare)

151 Mayo St
Suite B
Americus, GA 31709-4782
Phone (229) 928-2900

151 Mayo St a
Americus, GA 31709-4782
Phone (229) 312-5800

151 Mayo St C
Americus, GA 31709-4782
Phone (229) 928-2882

151 Mayo St D
Americus, GA 31709-4782
Phone (229) 928-1100

151 Mayo St E
Americus, GA 31709-4782
Phone (229) 931-1159

417 W 3Rd Ave
Albany, GA 31701-1943
Phone (229) 312-5222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.58 of 100Reported as group
Quality
55.5
Promoting interoperability
100
Improvement activities
40
Cost
71.46

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
101113GAMDUrology Physician
20791NVMDUrology Physician
83316-20WIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc CurrentSince Dec 8, 2023 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 8, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 8, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Dec 8, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Apr 1, 2025 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 8, 2023 Accepting new patients
Memorial Hospital Inc CurrentSince Dec 8, 2023 Accepting new patients
Phoebe Physician Group, Inc CurrentSince Apr 11, 2025 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 8, 2023 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Dec 8, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Dec 8, 2023 Accepting new patients
Marshfield Clinic Inc CurrentSince Dec 8, 2023 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Dec 8, 2023 Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: lanette.rickborn.1@8478.direct.athenahealth.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 2

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1174985444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "800-782-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 HARPER STREET MEDICAL OFFICE BUILDING SUITE 4G",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309125703",
            "telephone_number": "706-721-3042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N OAK AVE",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKBORN",
        "first_name": "LANETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "83316-20",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NV",
            "license": "20791",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "101113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1000 N OAK AVE",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lrickborn618380@directwellstar.org",
            "affiliation": "N",
            "address_1": "1000 N OAK AVE",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.