NPIMap

Individual provider Active NPI

Lauryn Carlson

  • Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1811431372
Registry record updated Feb 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
7441-33 Issued in WI
Practice address
1715 Dousman St
Green Bay, WI 54303-3211
Phone
(920) 496-4700
NPI assigned
Dec 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7441-33 WI Primary
Registered Nurse 163W00000X 168693-30 WI

Addresses

Primary practice location

1715 Dousman St
Green Bay, WI 54303-3211

Mailing address

PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700

Other names 1

  • Lauryn Pues Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170214001699 WI Practitioner - Nurse Practitioner 9638452832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1860 Shawano Ave
Green Bay, WI 54303-2667
Phone (920) 496-4700

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Green Bay, WI, CCN 520075
  • St Marys Hospital Medical Ctr Hospital, Green Bay, WI, CCN 520097
  • Door County Medical Center Hospital, Sturgeon Bay, WI, CCN 521358
  • HSHS St Clare Memorial Hospital Hospital, Oconto Falls, WI, CCN 521310

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
168693-30WIMDRegistered Nurse
7441-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Feb 6, 2017 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis CurrentSince Feb 6, 2017 Accepting new patients
St Vincent Hospital-Hospital Sisters-Third Order of St Francis Past Accepting new patients

Locations

3750 Investors Ct
Grand Chute, WI 54913

1860 Shawano Ave
Green Bay, WI 54303
Phone (920) 405-1414

1715 Dousman St
Green Bay, WI 54303

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

1821 S Webster Ave
Green Bay, WI 54301
Phone (920) 431-1850

Organizations & group practices 3

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 12

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": "1481846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486512000000",
    "number": "1811431372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19070",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543079070",
            "telephone_number": "920-496-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 DOUSMAN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033211",
            "telephone_number": "920-496-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "LAURYN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-16",
        "last_updated": "2017-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7441-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "168693-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURYN",
            "last_name": "PUES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.