Individual provider Active NPI

Brent James Lautenschlager, RT (R)

  • Radiography Radiologic Technologist
  • Bethel, AK
National Provider Identifier
1275771305
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiography Radiologic TechnologistTaxonomy code 2471C3402X
Practice address
700 Chief Eddie Hoffman Hwy
Radiology
Bethel, AK 99559
Phone
(907) 543-6238
NPI assigned
Jan 28, 2009
Last updated
Jan 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiography Radiologic Technologist 2471C3402X NU Primary

Addresses

Primary practice location

700 Chief Eddie Hoffman Hwy
Radiology
Bethel, AK 99559

Mailing address

233 5TH Ave N
Fort Dodge, IA 50501-3153
Phone (907) 543-6238

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": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1275771305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 5TH AVE N",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505013153",
            "telephone_number": "907-543-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHIEF EDDIE HOFFMAN HWY",
            "address_2": "RADIOLOGY",
            "city": "BETHEL",
            "state": "AK",
            "postal_code": "99559",
            "telephone_number": "907-543-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTENSCHLAGER",
        "first_name": "BRENT",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "RT (R)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethel, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.