Individual provider Active NPI

James L. Lauck Jr., D.O.

  • Specialist
  • Sioux City, IA
National Provider Identifier
1235190067
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
02805 Issued in IA
Practice address
1600 7TH St
Ste 101
Sioux City, IA 51101-2016
Phone
(712) 255-7474
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 02805 IA Primary

Addresses

Primary practice location

1600 7TH St
Ste 101
Sioux City, IA 51101-2016

Mailing address

1600 7TH Street
Ste 101
Sioux City, IA 51101
Phone (712) 255-7474

Other identifiers 5

IdentifierTypeStateIssuer
7767735MedicaidSD
10025457900MedicaidNE
P00361007OtherMEDICARE RAILROAD
1104604MedicaidIA
28656OtherWELLMARK BCBS OF IOWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170913002001 MN Order and Referring Only - Physical Medicine and RehabilitationPractitioner - Physical Medicine and Rehabilitation 7911950548

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02805IAMDSpecialist
5133SDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Health Resources Past Accepting new patients
Northwest Iowa Hospital Corporation Past Accepting new patients
St Lukes Health Resources Past Accepting new patients
St Lukes Health Resources Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1235190067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 7TH STREET",
            "address_2": "STE 101",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "51101",
            "telephone_number": "712-255-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH ST",
            "address_2": "STE 101",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511012016",
            "telephone_number": "712-255-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUCK",
        "first_name": "JAMES",
        "middle_name": "L.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IA",
            "license": "02805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7767735",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025457900",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00361007",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104604",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS OF IOWA",
            "identifier": "28656",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.