Active NPI
Vyvian Charlene Lawrence, DVM
- Emergency Medicine Physician
- Crown Point, IN
National Provider Identifier
1396358255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 090004455
- Practice address
- 5939 W Lincoln Hwy
Crown Point, IN 46307-9604 - Phone
- (219) 515-6904
- NPI assigned
- Aug 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 090004455 | IL | Primary |
Addresses
Primary practice location
5939 W Lincoln Hwy
Crown Point, IN 46307-9604
Mailing address
707 81St St
Downers Grove, IL 60516-4333
Phone (630) 664-8696
Other practice location 1
3667 Ridge Rd
Lansing, IL 60438-3340
Phone (708) 474-3100
Other practice location 2
707 81st St
Downers Grove, IL 60516-4333
Phone (639) 664-8696
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@crossroadsanimalhospital.org |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 090004455 | IL | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598572800000",
"number": "1396358255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 81ST ST",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605164333",
"telephone_number": "630-664-8696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5939 W LINCOLN HWY",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463079604",
"telephone_number": "219-515-6904"
}
],
"practiceLocations": [
{
"address_1": "3667 Ridge Rd",
"address_purpose": "LOCATION",
"city": "Lansing",
"state": "IL",
"postal_code": "604383340",
"country_code": "US",
"telephone_number": "708-474-3100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "707 81st St",
"address_purpose": "LOCATION",
"city": "Downers Grove",
"state": "IL",
"postal_code": "605164333",
"country_code": "US",
"telephone_number": "639-664-8696",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAWRENCE",
"first_name": "VYVIAN",
"middle_name": "CHARLENE",
"credential": "DVM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-28",
"last_updated": "2020-08-28",
"certification_date": "2020-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "090004455",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "info@crossroadsanimalhospital.org",
"affiliation": "N",
"address_1": "5939 W Lincoln Hwy",
"city": "Crown Point",
"state": "IN",
"country_code": "US",
"postal_code": "463079604",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Crown Point, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.