Individual provider Active NPI

Cynthia L Lecloux, A.P.N.P

  • Family Nurse Practitioner
  • Two Rivers, WI
National Provider Identifier
1841306206
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1844 Issued in WI
Practice address
3310 45TH St
Two Rivers, WI 54241-1049
Phone
(920) 793-3900
Fax
(920) 793-1542
NPI assigned
Aug 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1844 WI Primary

Addresses

Primary practice location

3310 45TH St
Two Rivers, WI 54241-1049

Mailing address

PO Box 2290
Manitowoc, WI 54221-2290
Phone (920) 320-2840

Other identifiers 1

IdentifierTypeStateIssuer
43936600MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1844WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Associates of Green Bay, LTD Past Accepting new patients
Holy Family Memorial Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1841306206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2290",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542212290",
            "telephone_number": "920-320-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 45TH ST",
            "city": "TWO RIVERS",
            "state": "WI",
            "postal_code": "542411049",
            "telephone_number": "920-793-3900",
            "fax_number": "920-793-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECLOUX",
        "first_name": "CYNTHIA",
        "middle_name": "L",
        "credential": "A.P.N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "1844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43936600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Two Rivers, WI

Sources for this page

Verify at the official NPI Registry.