Individual provider Active NPI

Elizabeth Maurene Lauterbach, PA-C

  • Physician Assistant
  • Wichita, KS
National Provider Identifier
1932535846
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-02729 Issued in KS
Practice address
9211 E 21St St N
Wichita, KS 67206-2900
Phone
(316) 527-4804
NPI assigned
Sep 24, 2013
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-02729 KS Primary

Addresses

Primary practice location

9211 E 21St St N
Wichita, KS 67206-2900

Mailing address

9211 E 21St St N
Wichita, KS 67206-2900
Phone (316) 527-4804

Other names 1

  • Elizabeth Maurene Olson Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ElizabethLauterbach@direct.jcmh.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230728002090 KS Practitioner - Physician Assistant 4688803323 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002447IAMDOptometrist
15-02729KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 6, 2023 Accepting new patients
Ascension Medical Group Via Christi, PA CurrentSince Jul 6, 2023 Accepting new patients
Ascension Medical Group Via Christi, PA Past Accepting new patients
Summit Medical Center Past Accepting new patients
Jackson County Memorial Hosp Phcy Past Accepting new patients

Locations

3311 E Murdock St
Wichita, KS 67208
Phone (316) 689-9107

9211 E 21st St N
Wichita, KS 67206
Phone (316) 609-4501

Interoperability endpoints

  • Direct secure messaging: elizabethlauterbach@direct.jcmh.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1932535846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9211 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062900",
            "telephone_number": "316-527-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9211 E 21ST ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062900",
            "telephone_number": "316-527-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUTERBACH",
        "first_name": "ELIZABETH",
        "middle_name": "MAURENE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-24",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-02729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ElizabethLauterbach@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "205 S Park Ln",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735215755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "OLSON",
            "middle_name": "MAURENE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.