Individual provider Active NPI

Lauren Marie Panner, FNP-BC

  • Family Nurse Practitioner
  • Naperville, IL
National Provider Identifier
1407269939
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209011026 Issued in IL
Practice address
636 Raymond Dr
Naperville, IL 60563-9791
Phone
(630) 355-5302
Fax
(630) 778-6088
NPI assigned
Jun 2, 2014
Last updated
Sep 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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 209011026 IL Primary
Registered Nurse 163W00000X 041407182 IL

Addresses

Primary practice location

636 Raymond Dr
Naperville, IL 60563-9791

Mailing address

636 Raymond Dr
Naperville, IL 60563-9791
Phone (630) 355-5302

Other names 1

  • Miss Lauren Marie Schultze Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20140709001609 IL Practitioner - Nurse Practitioner 3375768260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

636 Raymond Dr
Naperville, IL 60563-9789
Phone (630) 315-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041407182ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Aug 17, 2016 Accepting new patients
Central Dupage Physician Group CurrentSince Aug 17, 2016 Accepting new patients
Paragon Clinical Midwest, LLC Past Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

636 Raymond Dr
Naperville, IL 60563
Phone (630) 355-5302

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1407269939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639791",
            "telephone_number": "630-355-5302",
            "fax_number": "630-778-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639791",
            "telephone_number": "630-355-5302",
            "fax_number": "630-778-6088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNER",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011026",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041407182",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "SCHULTZE",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.