Individual provider Active NPI

Fred V Lause', D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Mt Sterling, KY
National Provider Identifier
1487703195
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
00225 Issued in KY
Practice address
1107 Indian Mound Dr
Ste C
Mt Sterling, KY 40353-1300
Phone
(859) 498-5151
Fax
(859) 498-8668
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 00225 KY Primary

Addresses

Primary practice location

1107 Indian Mound Dr
Ste C
Mt Sterling, KY 40353-1300

Mailing address

1107 Indian Mound Dr
Ste C
Mt Sterling, KY 40353-1300
Phone (859) 498-5151

Other identifiers 2

IdentifierTypeStateIssuer
00225OtherKYSTATE LICENSE NUMBER
80002256MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000698 KY Practitioner - Podiatry 9739194101 Practice locations: Mt Sterling, KY

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1107 Indian Mound Dr
Suite C
Mt Sterling, KY 40353-1300
Phone (859) 498-5151

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00225KYMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501718400000",
    "number": "1487703195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 INDIAN MOUND DR",
            "address_2": "STE C",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531300",
            "telephone_number": "859-498-5151",
            "fax_number": "859-498-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 INDIAN MOUND DR",
            "address_2": "STE C",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531300",
            "telephone_number": "859-498-5151",
            "fax_number": "859-498-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUSE'",
        "first_name": "FRED",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2017-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "00225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "00225",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80002256",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Sterling, KY

Sources for this page

Verify at the official NPI Registry.