Individual provider Active NPI

Lisa Jean Ladenburger, LADENBURGER LISA

  • Medical Art Specialist/Technologist
  • Sioux Falls, SD
National Provider Identifier
1538466834
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Art Specialist/TechnologistTaxonomy code 246ZA2600X
License
1023-9814-ST Issued in SD
Practice address
1700 S Minnesota Ave
Sioux Falls, SD 57105-1723
Phone
(605) 376-1615
Fax
(605) 339-3778
NPI assigned
Feb 22, 2011
Last updated
Feb 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Art Specialist/Technologist 246ZA2600X 1023-9814-ST SD Primary

Addresses

Primary practice location

1700 S Minnesota Ave
Sioux Falls, SD 57105-1723

Mailing address

2908 S Bellepine Cir
Sioux Falls, SD 57103-4800
Phone (605) 376-1615

Other names 1

  • Lisa Jean Ladenburger Professional name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1023-9814-STSDMDMedical Art Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Acucare Physical Therapy, LTD PastSince May 1, 2002 Accepting new patients
North Central Urology PC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298332800000",
    "number": "1538466834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 S BELLEPINE CIR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571034800",
            "telephone_number": "605-376-1615",
            "fax_number": "605-339-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S MINNESOTA AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051723",
            "telephone_number": "605-376-1615",
            "fax_number": "605-339-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADENBURGER",
        "first_name": "LISA",
        "middle_name": "JEAN",
        "credential": "LADENBURGER LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-22",
        "last_updated": "2011-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZA2600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Art, Medical",
            "state": "SD",
            "license": "1023-9814-ST",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LADENBURGER",
            "middle_name": "JEAN",
            "credential": "BREASTHETICIAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; 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.