Individual provider Active NPI

Lance Allan Woodyard

  • Licensed Practical Nurse
  • Waterloo, IA
National Provider Identifier
1861354201
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
P53464 Issued in IA
Practice address
4000 University Ave
Waterloo, IA 50701-5656
Phone
(319) 235-1230
Fax
(319) 226-8417
NPI assigned
Nov 24, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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 P53464 IA Primary

Addresses

Primary practice location

4000 University Ave
Waterloo, IA 50701-5656

Mailing address

4000 University Ave
Waterloo, IA 50701-5656
Phone (319) 235-1230

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
P53464IAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1861354201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 UNIVERSITY AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015656",
            "telephone_number": "319-235-1230",
            "fax_number": "319-226-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 UNIVERSITY AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507015656",
            "telephone_number": "319-235-1230",
            "fax_number": "319-226-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODYARD",
        "first_name": "LANCE",
        "middle_name": "ALLAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-24",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P53464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.