Individual provider Active NPI

Mary Lou Herbst, LPN

  • Licensed Practical Nurse
  • Lake Mills, WI
National Provider Identifier
1831438407
Registry record updated Feb 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
315524-31 Issued in WI
Practice address
555 Connor CT
Lake Mills, WI 53551-1665
Phone
(920) 342-7748
NPI assigned
Feb 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 315524-31 WI Primary

Addresses

Primary practice location

555 Connor CT
Lake Mills, WI 53551-1665

Mailing address

555 Connor CT
Lake Mills, WI 53551-1665
Phone (920) 342-7748

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
315524-31WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1359763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359763200000",
    "number": "1831438407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 CONNOR CT",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535511665",
            "telephone_number": "920-342-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 CONNOR CT",
            "city": "LAKE MILLS",
            "state": "WI",
            "postal_code": "535511665",
            "telephone_number": "920-342-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBST",
        "first_name": "MARY",
        "middle_name": "LOU",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-02",
        "last_updated": "2013-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "315524-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mills, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2013; 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.