Individual provider Active NPI

Lawrence Holbert, RN

  • Registered Nurse
  • Crescent City, CA
National Provider Identifier
1659501864
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
751763 Issued in CA
Practice address
550 E Washington Blvd
Suite 100
Crescent City, CA 95531-8160
Phone
(707) 465-6925
Fax
(707) 465-6070
NPI assigned
Jul 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 751763 CA Primary

Addresses

Primary practice location

550 E Washington Blvd
Suite 100
Crescent City, CA 95531-8160

Mailing address

670 9TH St
Suite 203
Arcata, CA 95521-6248
Phone (707) 826-8633

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

LicenseStateTypeSpecialty
751763CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1659501864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 9TH ST",
            "address_2": "SUITE 203",
            "city": "ARCATA",
            "state": "CA",
            "postal_code": "955216248",
            "telephone_number": "707-826-8633",
            "fax_number": "707-826-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E WASHINGTON BLVD",
            "address_2": "SUITE 100",
            "city": "CRESCENT CITY",
            "state": "CA",
            "postal_code": "955318160",
            "telephone_number": "707-465-6925",
            "fax_number": "707-465-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBERT",
        "first_name": "LAWRENCE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "751763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.