Individual provider Active NPI

Susan Mary Lawbaugh

  • Registered Nurse
  • Sturgeon Bay, WI
National Provider Identifier
1710218250
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
116729-030 Issued in WI
Practice address
6473 Sawyer Dr
Sturgeon Bay, WI 54235-9001
Phone
(920) 743-7906
NPI assigned
Jan 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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 116729-030 WI Primary

Addresses

Primary practice location

6473 Sawyer Dr
Sturgeon Bay, WI 54235-9001

Mailing address

6473 Sawyer Dr
Sturgeon Bay, WI 54235-9001
Phone (920) 743-7906

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
116729-030WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1264118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1710218250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6473 SAWYER DR",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542359001",
            "telephone_number": "920-743-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6473 SAWYER DR",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542359001",
            "telephone_number": "920-743-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWBAUGH",
        "first_name": "SUSAN",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-22",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "116729-030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturgeon Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2010; 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.