Individual provider Active NPI

Paul Lanciault, CPO

  • Prosthetist
  • Temple, TX
National Provider Identifier
1205305075
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
Practice address
1901 S 1St St
Temple, TX 76504-7451
Phone
(254) 743-2416
Fax
(254) 743-2348
NPI assigned
Nov 21, 2018
Last updated
Nov 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X
Prosthetist 224P00000X Primary

Addresses

Primary practice location

1901 S 1St St
Temple, TX 76504-7451

Mailing address

1901 S 1St St
Temple, TX 76504-7451
Phone (254) 743-2416

Other identifiers 1

IdentifierTypeStateIssuer
CPO03232OtherAMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS

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": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1205305075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S 1ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765047451",
            "telephone_number": "254-743-2416",
            "fax_number": "254-743-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S 1ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765047451",
            "telephone_number": "254-743-2416",
            "fax_number": "254-743-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCIAULT",
        "first_name": "PAUL",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS",
            "identifier": "CPO03232",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.