NPIMap

Organization Active NPI

Lawrence Otolaryngology Associates, LLC

  • Specialist
  • Lawrence, KS
National Provider Identifier
1972516599
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
LAWRENCE OTOLARYNGOLOGY ASSOCIATES, LLC
Practice address
1112 W 6TH St
Suite 216
Lawrence, KS 66044-2215
Phone
(785) 841-1107
Fax
(785) 841-1173
NPI assigned
Aug 14, 2006
Last updated
Apr 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Cortney Kelly
Title
Administrator
Phone
(785) 841-1107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1112 W 6TH St
Suite 216
Lawrence, KS 66044-2215

Mailing address

1112 W 6TH St
Suite 216
Lawrence, KS 66044-2215
Phone (785) 841-1107

Other practice location 1

1302 S Main St Ste 5
Ottawa, KS 66067-3533
Phone (785) 242-3300

Other identifiers 1

IdentifierTypeStateIssuer
100215660AMedicaidKS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301001081 KS Part B Supplier - Clinic/Group Practice 2466349865 Receives reassigned benefits from 12 practitioners
Practice locations: Lawrence, KS; Ottawa, KS

National Provider Directory

National Provider Directory

Locations

1302 S Main St
Ste 5
Ottawa, KS 66067
Phone (785) 242-3300

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1972516599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 W 6TH ST",
            "address_2": "SUITE 216",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442215",
            "telephone_number": "785-841-1107",
            "fax_number": "785-841-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 W 6TH ST",
            "address_2": "SUITE 216",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442215",
            "telephone_number": "785-841-1107",
            "fax_number": "785-841-1173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1302 S Main St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Ottawa",
            "state": "KS",
            "postal_code": "660673533",
            "country_code": "US",
            "telephone_number": "785-242-3300",
            "fax_number": "785-841-1173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAWRENCE OTOLARYNGOLOGY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "CORTNEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "785-841-1107"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100215660A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.