Lauren Nicole Sederholm, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA07293 Issued in TX

Practice address

4407 Bee Caves Rd Ste 612
West Lake Hills, TX 78746-5285

Phone

(512) 446-9486

Fax

(512) 597-0402

NPI assigned

May 10, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Pediatric Surgical Subspecialists

  • Pediatric Critical Care Medicine Physician
  • Austin, TX
  • NPI 1184815227
  NPD (past)
• Seton Family of Doctors

  • Radiology Clinic/Center
  • Austin, TX
  • NPI 1275290694
  NPD (past)

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1720370760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 889230",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900889230",
            "telephone_number": "512-446-9486",
            "fax_number": "512-597-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 BEE CAVES RD STE 612",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465285",
            "telephone_number": "512-446-9486",
            "fax_number": "512-597-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDERHOLM",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-10",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07293",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA07293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287558505",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew Schnurr, LMT
• Eric Daniel Schultz, D.O.
• Michael A Schwartz, M.D.
• Michel Orion Scott, LPC
• Scruggs Family Holdings, Inc.
• Gabriella Anne Segovia, PT, DPT
• Select Physical Therapy Texas Limited Partnership
• Seth M Hollander, MD PA
• Lauren N Shafford
• Sarah Shah, LPC

• Surgical Physician Assistant in West Lake Hills, TX
• Providers in West Lake Hills, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.