Individual provider Active NPI

Vicky Ann Lawrence

  • Certified Registered Nurse Anesthetist
  • Sheboygan, WI
National Provider Identifier
1861760753
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
167201-30 Issued in WI
Practice address
2629 N 7TH St
Aurora Sheboygan Memorial Medical Center
Sheboygan, WI 53083-4932
Phone
(920) 451-5588
Fax
(920) 451-5143
NPI assigned
Dec 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 167201-30 WI Primary

Addresses

Primary practice location

2629 N 7TH St
Aurora Sheboygan Memorial Medical Center
Sheboygan, WI 53083-4932

Mailing address

2629 N 7TH St
Aurora Sheboygan Memorial Medical Center
Sheboygan, WI 53083-4932
Phone (608) 213-2523

Other names 1

  • Vicky Ann Vander Heiden Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120524000262 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163685454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Wisconsin AnesthesiologyGroup PAC ID 5597667097, 57 clinicians

Practice addresses (Care Compare)

425 Pine Ridge Blvd
Suite 211
Wausau, WI 54401-4123
Phone (715) 845-5505

Hospital & facility affiliations

  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030

Merit-based Incentive Payment System (MIPS)

Final score
79.11 of 100Reported as group
Quality
74.74
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
167201-30WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Wisconsin Anesthesiology CurrentSince Jun 21, 2021 Accepting new patients

Locations

425 Pine Ridge Blvd
Ste 21
Wausau, WI 54401

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401
Phone (715) 845-5505

Organizations & group practices 1

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 10

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": "1323129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1861760753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 N 7TH ST",
            "address_2": "AURORA SHEBOYGAN MEMORIAL MEDICAL CENTER",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834932",
            "telephone_number": "608-213-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2629 N 7TH ST",
            "address_2": "AURORA SHEBOYGAN MEMORIAL MEDICAL CENTER",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834932",
            "telephone_number": "920-451-5588",
            "fax_number": "920-451-5143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "VICKY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-06",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "167201-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKY",
            "last_name": "VANDER HEIDEN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.