Individual provider Active NPI

Rita Marie Luedke, CRNA

  • Certified Registered Nurse Anesthetist
  • Green Bay, WI
National Provider Identifier
1497797971
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
49409 Issued in WI
Practice address
744 S Webster Ave
455 S River Road
Green Bay, WI 54301-3505
Phone
(920) 445-7226
Fax
(920) 445-7229
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 49409 WI
Certified Registered Nurse Anesthetist 367500000X 49409 WI Primary

Addresses

Primary practice location

744 S Webster Ave
455 S River Road
Green Bay, WI 54301-3505

Mailing address

744 S Webster Ave
455 S River Road
Green Bay, WI 54301-3505
Phone (920) 445-7226

Other identifiers 1

IdentifierTypeStateIssuer
43350900MedicaidWI

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
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
49409WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Healthcare Partners, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Black River Health Inc Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Anesthesia Services of the Fox Valley SC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rluedke291859@direct.emplifyhealth.org

Organizations & group practices 5

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": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460332800000",
    "number": "1497797971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "address_2": "455 S RIVER ROAD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "address_2": "455 S RIVER ROAD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEDKE",
        "first_name": "RITA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2016-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "WI",
            "license": "49409",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "49409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43350900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.