Individual provider Active NPI

Lara Lea Kyhl, ARNP

  • Family Nurse Practitioner
  • Shell Rock, IA
National Provider Identifier
1467543124
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A095740 Issued in IA
Practice address
1001 Mason Way
Shell Rock, IA 50670-1007
Phone
(319) 885-6530
Fax
(877) 325-1948
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A095740 IA Primary

Addresses

Primary practice location

1001 Mason Way
Shell Rock, IA 50670-1007

Mailing address

31379 302ND St
New Hartford, IA 50660-8602
Phone (319) 240-8116

Other practice location 1

312 9th St SW
Waverly, IA 50677-2999
Phone (319) 352-4120

Other identifiers 1

IdentifierTypeStateIssuer
1467543124MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20180123000580 IA Practitioner - Nurse Practitioner 1850397779 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A095740IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Waverly Health Center CurrentSince Jan 15, 2018 Accepting new patients
Waverly Health Center CurrentSince Jun 6, 2006 Accepting new patients
Waverly Health Center CurrentSince Jun 6, 2006 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

1001 Mason Way
Shell Rock, IA 50670
Phone (319) 885-6530

312 9th St SW
Waverly, IA 50677
Phone (319) 352-4120

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1467543124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31379 302ND ST",
            "city": "NEW HARTFORD",
            "state": "IA",
            "postal_code": "506608602",
            "telephone_number": "319-240-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MASON WAY",
            "city": "SHELL ROCK",
            "state": "IA",
            "postal_code": "506701007",
            "telephone_number": "319-885-6530",
            "fax_number": "877-325-1948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "312 9th St SW",
            "address_purpose": "LOCATION",
            "city": "Waverly",
            "state": "IA",
            "postal_code": "506772999",
            "country_code": "US",
            "telephone_number": "319-352-4120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KYHL",
        "first_name": "LARA",
        "middle_name": "LEA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A095740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467543124",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shell Rock, IA

Sources for this page

Verify at the official NPI Registry.