Individual provider Active NPI

Laurie Ann Housworth, DDS

  • General Practice Dentistry
  • The Villages, FL
National Provider Identifier
1023088085
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012509 Issued in GA
Practice address
8900 SE 165TH Mulberry Lane
The Villages VA Outpatient Clinic
The Villages, FL 32162
Phone
(352) 674-5000
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012509 GA Primary
General Practice Dentistry 1223G0001X HAD7 FL

Addresses

Primary practice location

8900 SE 165TH Mulberry Lane
The Villages VA Outpatient Clinic
The Villages, FL 32162

Mailing address

8900 SE 165TH Mulberry Lane
The Villages VA Outpatient Clinic
The Villages, FL 32162
Phone (352) 674-5000

Other identifiers 1

IdentifierTypeStateIssuer
0767131-00MedicaidFL

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
HAD7FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1023088085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 SE 165TH MULBERRY LANE",
            "address_2": "THE VILLAGES VA OUTPATIENT CLINIC",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "32162",
            "telephone_number": "352-674-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 SE 165TH MULBERRY LANE",
            "address_2": "THE VILLAGES VA OUTPATIENT CLINIC",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "32162",
            "telephone_number": "352-674-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSWORTH",
        "first_name": "LAURIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012509",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "HAD7",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0767131-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.