Individual provider Active NPI

Carol Ann Lamoureux-Lewallen, DNP. ARNP

  • Family Nurse Practitioner
  • Spencer, IA
National Provider Identifier
1669756474
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A-083751 Issued in IA
Practice address
116 E 7TH St
Suite 2
Spencer, IA 51301-4018
Phone
(712) 580-6592
Fax
(712) 580-6593
NPI assigned
Sep 29, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A-083751 IA Primary

Addresses

Primary practice location

116 E 7TH St
Suite 2
Spencer, IA 51301-4018

Mailing address

116 E 7TH St
Ste 2
Spencer, IA 51301-4018
Phone (712) 580-6592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20121101000026 IA Practitioner - Nurse Practitioner 0042460453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

116 E 7TH St
Suite 2
Spencer, IA 51301-4054
Phone (712) 580-6592

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A-083751IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Convenient Healthcare LLC CurrentSince Sep 24, 2012 Accepting new patients

Locations

116 E 7th St
Ste 2
Spencer, IA 51301
Phone (712) 260-6592

116 E 7th St
Spencer, IA 51301

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23712/brand/1/csg/1/fhir/r4
  • Direct secure messaging: carol.lamoureux-lewallen.1@23712.direct.athenahealth.com

Organizations & group practices 1

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1669756474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 E 7TH ST",
            "address_2": "STE 2",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014018",
            "telephone_number": "712-580-6592",
            "fax_number": "712-580-6593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E 7TH ST",
            "address_2": "SUITE 2",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014018",
            "telephone_number": "712-580-6592",
            "fax_number": "712-580-6593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMOUREUX-LEWALLEN",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "DNP. ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A-083751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

Verify at the official NPI Registry.