Active NPI
Sue Ann Lazar, MSN
- Family Nurse Practitioner
- Indianapolis, IN
National Provider Identifier
1326033119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 28047856A
- Practice address
- 1225 W 86TH St
Indianapolis, IN 46260-2203 - Phone
- (317) 253-6427
- NPI assigned
- Sep 16, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 28047856A | IN | Primary |
Addresses
Primary practice location
1225 W 86TH St
Indianapolis, IN 46260-2203
Mailing address
2970 Belle Maison Dr
Zionsville, IN 46077-8901
Phone (317) 769-5089
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200188230A | Medicaid | IN |
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)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28047856A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minuteclinic Diagnostics of Indiana, LLC | Family | Past | Accepting new patients |
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.
-
- Family Nurse Practitioner
- Zionsville, IN
- NPI 1932171634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231804800000",
"number": "1326033119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2970 BELLE MAISON DR",
"city": "ZIONSVILLE",
"state": "IN",
"postal_code": "460778901",
"telephone_number": "317-769-5089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 W 86TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602203",
"telephone_number": "317-253-6427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZAR",
"first_name": "SUE",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "MSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-16",
"last_updated": "2009-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "28047856A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200188230A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.