Individual provider Active NPI

Lauren Juliano

  • Emergency Medicine Physician
  • Salmon, ID
National Provider Identifier
1982224481
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M17890 Issued in ID
Practice address
203 S Daisy St
Salmon, ID 83467-4709
Phone
(208) 756-5728
NPI assigned
Apr 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician 207PS0010X M17890 ID
Emergency Medicine Physician 207P00000X M17890 ID Primary

Addresses

Primary practice location

203 S Daisy St
Salmon, ID 83467-4709

Mailing address

203 S Daisy St
Salmon, ID 83467-4709
Phone (248) 807-2320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240906002609 ID Practitioner - Emergency MedicinePractitioner - Sports Medicine 4981025434 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M17890IDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steele Memorial Medical Center CurrentSince Aug 1, 2024 Accepting new patients
Steele Memorial Medical Center CurrentSince Aug 1, 2024 Accepting new patients

Locations

203 S Daisy St
Salmon, ID 83467
Phone (208) 756-4291

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1587686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1982224481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S DAISY ST",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674709",
            "telephone_number": "248-807-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S DAISY ST",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674709",
            "telephone_number": "208-756-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JULIANO",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-24",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "ID",
            "license": "M17890",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M17890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salmon, ID

Sources for this page

Verify at the official NPI Registry.