Individual provider Active NPI

Kory E Lueck, CSW

  • Case Manager/Care Coordinator
  • La Crosse, WI
National Provider Identifier
1659663391
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
9567-120 Issued in WI
Practice address
1407 Saint Andrew St Ste 100
La Crosse, WI 54603-2378
Phone
(608) 372-3109
NPI assigned
May 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 9567-120 WI Primary

Addresses

Primary practice location

1407 Saint Andrew St Ste 100
La Crosse, WI 54603-2378

Mailing address

1811 Superior Ave
Tomah, WI 54660-2745
Phone (608) 633-2403

Other names 1

  • Ms. Kory E Brandau Former 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
9567-120WIMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1659663391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 SUPERIOR AVE",
            "city": "TOMAH",
            "state": "WI",
            "postal_code": "546602745",
            "telephone_number": "608-633-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 SAINT ANDREW ST STE 100",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546032378",
            "telephone_number": "608-372-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUECK",
        "first_name": "KORY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "CSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "WI",
            "license": "9567-120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KORY",
            "last_name": "BRANDAU",
            "middle_name": "E",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.