Individual provider Active NPI

Carla Tautges, LPN

  • Licensed Practical Nurse
  • Wausau, WI
National Provider Identifier
1255636189
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
30351131 Issued in WI
Practice address
209 W Washington St
Suite B
Wausau, WI 54403-5475
Phone
(715) 845-3637
NPI assigned
Jan 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 30351131 WI Primary

Addresses

Primary practice location

209 W Washington St
Suite B
Wausau, WI 54403-5475

Mailing address

209 W Washington St
Suite B
Wausau, WI 54403-5475
Phone (715) 845-3637

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

State licenses

LicenseStateTypeSpecialty
30351131WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1255636189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W WASHINGTON ST",
            "address_2": "SUITE B",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035475",
            "telephone_number": "715-845-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W WASHINGTON ST",
            "address_2": "SUITE B",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035475",
            "telephone_number": "715-845-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUTGES",
        "first_name": "CARLA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "30351131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.