Individual provider Active NPI

Lori A Cheney, APN

  • Primary Care Nurse Practitioner
  • Prescott, AZ
National Provider Identifier
1326081720
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP2298 Issued in AZ
Practice address
500 N US Highway 89
Northern Arizona VA HCS (Navahcs)
Prescott, AZ 86313
Phone
(928) 445-4860
Fax
(928) 680-0430
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP2298 AZ
Primary Care Nurse Practitioner 363LP2300X AP2298 AZ Primary

Addresses

Primary practice location

500 N US Highway 89
Northern Arizona VA HCS (Navahcs)
Prescott, AZ 86313

Mailing address

500 N US Highway 89
Northern Arizona VA HCS (Navahcs)
Prescott, AZ 86313
Phone (928) 445-4860

Other identifiers 1

IdentifierTypeStateIssuer
991936MedicaidAZ

Other names 1

  • Ms. Lori A Gronquist Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20121119000472 AZ Order and Referring Only - Nurse Practitioner 7012937428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP2298AZMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1326081720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N US HIGHWAY 89",
            "address_2": "NORTHERN ARIZONA VA HCS (NAVAHCS)",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86313",
            "telephone_number": "928-445-4860",
            "fax_number": "928-680-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N US HIGHWAY 89",
            "address_2": "NORTHERN ARIZONA VA HCS (NAVAHCS)",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86313",
            "telephone_number": "928-445-4860",
            "fax_number": "928-680-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENEY",
        "first_name": "LORI",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP2298",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP2298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "991936",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "GRONQUIST",
            "middle_name": "A",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.