Individual provider Active NPI

Laura A Rockendorf, APNP

  • Nurse Practitioner
  • Sturgeon Bay, WI
National Provider Identifier
1437520772
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6673 Issued in WI
Practice address
1910 Alabama St
Sturgeon Bay, WI 54235-3532
Phone
(920) 746-7200
NPI assigned
Oct 13, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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 6673 WI Primary

Addresses

Primary practice location

1910 Alabama St
Sturgeon Bay, WI 54235-3532

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 389-2131

Other names 1

  • Laura A Boucher Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lboucher141573@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20260416001546 WI Order and Referring Only - Nurse Practitioner 4385954353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6673WIMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: lboucher141573@direct.myadvocateaurora.org

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1437520772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-389-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 ALABAMA ST",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542353532",
            "telephone_number": "920-746-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCKENDORF",
        "first_name": "LAURA",
        "middle_name": "A",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-13",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lboucher141573@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1910 Alabama St",
            "city": "Sturgeon Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542353532",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1910 Alabama St",
            "city": "Sturgeon Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542353532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BOUCHER",
            "middle_name": "A",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sturgeon Bay, WI

Sources for this page

Verify at the official NPI Registry.