Active NPI
Connie Lueck, R.N.
- Registered Nurse
- Madison, WI
National Provider Identifier
1609185008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 105298-30
- Practice address
- 834 Jupiter Dr
#304
Madison, WI 53718-2960 - Phone
- (608) 630-3823
- NPI assigned
- Oct 2, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 105298-30 | WI | Primary |
| Wound Care Registered Nurse | 163WW0000X | 105298-30 | WI |
Addresses
Primary practice location
834 Jupiter Dr
#304
Madison, WI 53718-2960
Mailing address
834 Jupiter Dr
#304
Madison, WI 53718-2960
Phone (608) 630-3823
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105298-30 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285977600000",
"number": "1609185008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "834 JUPITER DR",
"address_2": "#304",
"city": "MADISON",
"state": "WI",
"postal_code": "537182960",
"telephone_number": "608-630-3823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "834 JUPITER DR",
"address_2": "#304",
"city": "MADISON",
"state": "WI",
"postal_code": "537182960",
"telephone_number": "608-630-3823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUECK",
"first_name": "CONNIE",
"credential": "R.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-02",
"last_updated": "2010-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "105298-30",
"primary": true
},
{
"code": "163WW0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Wound Care",
"state": "WI",
"license": "105298-30",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.