Individual provider Active NPI

Kerri Ann Lauchner, PA-C

  • Medical Physician Assistant
  • Thousand Oaks, CA
National Provider Identifier
1255536066
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA15782 Issued in CA
Practice address
3240 Luther Ave
Thousand Oaks, CA 91360-2715
Phone
(805) 493-3225
Fax
(805) 493-3955
NPI assigned
Jun 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA15782 CA Primary

Addresses

Primary practice location

3240 Luther Ave
Thousand Oaks, CA 91360-2715

Mailing address

60 W Olsen Rd # 4300
Thousand Oaks, CA 91360-2700
Phone (805) 493-3225

Other identifiers 1

IdentifierTypeStateIssuer
WPA15782AMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613000988 CA Practitioner - Physician Assistant 4284678061 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA15782CAMDMedical Physician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1255536066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 W OLSEN RD # 4300",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913602700",
            "telephone_number": "805-493-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 LUTHER AVE",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913602715",
            "telephone_number": "805-493-3225",
            "fax_number": "805-493-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUCHNER",
        "first_name": "KERRI",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA15782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WPA15782A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.