Individual provider Active NPI

Lois Pancratz, ARNP

  • Nurse Practitioner
  • Dubuque, IA
National Provider Identifier
1417926155
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A045352 Issued in IA
Practice address
350 N Grandview Ave
Dubuque, IA 52001-6388
Phone
(563) 582-1881
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A045352 IA Primary

Addresses

Primary practice location

350 N Grandview Ave
Dubuque, IA 52001-6388

Mailing address

350 N Grandview Ave
Dubuque, IA 52001-6388
Phone (563) 582-1881

Other identifiers 1

IdentifierTypeStateIssuer
0430553MedicaidIA

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

State licenses

LicenseStateTypeSpecialty
04532IAMDSocial Worker
A045352IAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191369600000",
    "number": "1417926155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N GRANDVIEW AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016388",
            "telephone_number": "563-582-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N GRANDVIEW AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016388",
            "telephone_number": "563-582-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCRATZ",
        "first_name": "LOIS",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2007-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "A045352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0430553",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.