Individual provider Active NPI

Lauren E Liebling, PA-C

  • Physician Assistant
  • Wenatchee, WA
National Provider Identifier
1639525132
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60767794 Issued in WA
Practice address
820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone
(509) 663-8711
NPI assigned
May 13, 2016
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60767794 WA Primary

Addresses

Primary practice location

820 N Chelan Ave
Wenatchee, WA 98801-2028

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028

Other identifiers 3

IdentifierTypeStateIssuer
G8970443OtherWAWVH MEDICARE PTAN
1639525132MedicaidWA
G8970444OtherWAWVH MEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170926001674 WA Practitioner - Physician Assistant 3779857073 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60767794WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chelan County Public Hospital District No. 1 CurrentSince Jun 26, 2023 Accepting new patients
Central Washington Health Services Association CurrentSince Sep 1, 2019 Accepting new patients
Ozark Tri-County Health Care Consortium Past Accepting new patients

Locations

817 Commercial St
Leavenworth, WA 98826
Phone (509) 548-3420

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

Interoperability endpoints

  • Direct secure messaging: lliebling49269@edirect.chehr.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, 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": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1639525132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBLING",
        "first_name": "LAUREN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-13",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60767794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WVH MEDICARE PTAN",
            "identifier": "G8970443",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639525132",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WVH MEDICARE PTAN",
            "identifier": "G8970444",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.