Individual provider Active NPI

Laura K Schmid-Tyler, P.A.-C

  • Physician Assistant
  • Rice Lake, WI
National Provider Identifier
1851377444
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2702 Issued in WI
Practice address
1700 W Stout St
Rice Lake, WI 54868-5000
Phone
(715) 236-8100
NPI assigned
Dec 16, 2005
Last updated
Nov 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2702 WI Primary
Physician Assistant 363A00000X 1334 MN

Addresses

Primary practice location

1700 W Stout St
Rice Lake, WI 54868-5000

Mailing address

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGMedicaidMN
PENDINGOtherMNBXBS

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1334MNMDPhysician Assistant
2702WIMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291075200000",
    "number": "1851377444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 N OAK AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544495703",
            "telephone_number": "715-387-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W STOUT ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548685000",
            "telephone_number": "715-236-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMID-TYLER",
        "first_name": "LAURA",
        "middle_name": "K",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2010-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2702",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1334",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXBS",
            "identifier": "PENDING",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

Verify at the official NPI Registry.