NPIMap

Individual provider Active NPI

Laurel Lueth

  • Physician Assistant
  • Wichita, KS
National Provider Identifier
1184291809
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-02520 Issued in KS
Practice address
2750 S Roosevelt St
Wichita, KS 67210-1304
Phone
(316) 262-2415
NPI assigned
Jun 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 15-02520 KS Primary

Addresses

Primary practice location

2750 S Roosevelt St
Wichita, KS 67210-1304

Mailing address

2750 S Roosevelt St
Wichita, KS 67210-1304
Phone (316) 262-2415

Other names 1

  • Laurel Burton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240621003809 AR Practitioner - Physician Assistant 9032507330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Heart Hospital LLCGroup PAC ID 6002838653, 85 clinicians

Practice addresses (Care Compare)

1701 S Shackleford Rd
Little Rock, AR 72211-4335

7 Shackleford W Blvd
Little Rock, AR 72211-3886
Phone (501) 664-5860

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Heart Hospital, LLC CurrentSince May 23, 2024 Accepting new patients

Locations

7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671

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.

Hospital & facility affiliations 10

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": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1184291809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 S ROOSEVELT ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672101304",
            "telephone_number": "316-262-2415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 S ROOSEVELT ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672101304",
            "telephone_number": "316-262-2415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUETH",
        "first_name": "LAUREL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "BURTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.