Individual provider Active NPI

Laurel J Runte, APNP

  • Pediatric Nurse Practitioner
  • Fort Atkinson, WI
National Provider Identifier
1689607004
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
543-33 Issued in WI
Practice address
426 McMillen St
Fort Atkinson, WI 53538-1996
Phone
(920) 563-5500
Fax
(920) 563-4472
NPI assigned
Jul 9, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 87913-030 WI
Pediatric Nurse Practitioner 363LP0200X 543-33 WI Primary

Addresses

Primary practice location

426 McMillen St
Fort Atkinson, WI 53538-1996

Mailing address

426 McMillen St
Fort Atkinson, WI 53538-1996
Phone (920) 563-5500

Other identifiers 1

IdentifierTypeStateIssuer
43841100MedicaidWI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
87913-030WIMDRegistered Nurse

Interoperability endpoints

  • Direct secure messaging: laurel.runte@direct.forthc.com

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1689607004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 MCMILLEN ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381996",
            "telephone_number": "920-563-5500",
            "fax_number": "920-563-4472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 MCMILLEN ST",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381996",
            "telephone_number": "920-563-5500",
            "fax_number": "920-563-4472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNTE",
        "first_name": "LAUREL",
        "middle_name": "J",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "87913-030",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "543-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43841100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.