Individual provider Active NPI

Lee Ann Laroy, FNP-C

  • Family Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1477116291
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
024370 Issued in OH
Practice address
3900 Sunforest CT
Suite 215
Toledo, OH 43623
Phone
(419) 473-6670
Fax
(419) 473-9959
NPI assigned
Apr 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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 4704323763 MI
Family Nurse Practitioner 363LF0000X 024370 OH Primary

Addresses

Primary practice location

3900 Sunforest CT
Suite 215
Toledo, OH 43623

Mailing address

3900 Sunforest CT
Suite 215
Toledo, OH 43623
Phone (419) 473-6670

Other names 1

  • Lee Ann Lyczkowski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190513000766 OH Practitioner - Nurse Practitioner 6901149004 Reassigns benefits to 1 organization
I20201021000859 MI Practitioner - Nurse Practitioner 6901149004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024370OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Toledo Urgent Care LLC Past Accepting new patients
The Pediatric Center, Inc. PastSince Nov 20, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1477116291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 SUNFOREST CT",
            "address_2": "SUITE 215",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43623",
            "telephone_number": "419-473-6670",
            "fax_number": "419-473-9959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 SUNFOREST CT",
            "address_2": "SUITE 215",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43623",
            "telephone_number": "419-473-6670",
            "fax_number": "419-473-9959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROY",
        "first_name": "LEE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704323763",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "024370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEE",
            "last_name": "LYCZKOWSKI",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.