Individual provider Active NPI

Andreas Michael Staver, RN

  • Orthopedic Registered Nurse
  • North Liberty, IA
National Provider Identifier
1932480423
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Registered NurseTaxonomy code 163WX0800X
License
117890 Issued in IA
Practice address
110 Lynx LN
North Liberty, IA 52317-9001
Phone
(319) 471-3369
NPI assigned
Aug 29, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Registered Nurse 163WX0800X 117890 IA Primary

Addresses

Primary practice location

110 Lynx LN
North Liberty, IA 52317-9001

Mailing address

110 Lynx LN
North Liberty, IA 52317-9001
Phone (319) 471-3369

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
117890IAMDOrthopedic Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314576000000",
    "number": "1932480423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LYNX LN",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179001",
            "telephone_number": "319-471-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LYNX LN",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179001",
            "telephone_number": "319-471-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAVER",
        "first_name": "ANDREAS",
        "middle_name": "MICHAEL",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-29",
        "last_updated": "2011-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "IA",
            "license": "117890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.