Individual provider Active NPI

Lauren Petru

  • Case Manager/Care Coordinator
  • Las Vegas, NV
National Provider Identifier
1184987562
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
4160 S Pecos Rd Ste 17
Las Vegas, NV 89121-5027
Phone
(702) 332-8466
NPI assigned
Jun 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Case Manager/Care Coordinator 171M00000X CA Primary

Addresses

Primary practice location

4160 S Pecos Rd Ste 17
Las Vegas, NV 89121-5027

Mailing address

1981 Sycamore CT
McKinleyville, CA 95519-3901

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

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1184987562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1981 SYCAMORE CT",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955193901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 S PECOS RD STE 17",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215027",
            "telephone_number": "702-332-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRU",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.