Individual provider Active NPI

Lauren Johnston Colletti, FNP-C

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1033464326
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP12206 Issued in TX
Practice address
4107 Medical Pkwy Ste 208
Austin, TX 78756-3729
Phone
(512) 980-9861
Fax
(512) 599-9124
NPI assigned
Jul 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP12206 TX Primary

Addresses

Primary practice location

4107 Medical Pkwy Ste 208
Austin, TX 78756-3729

Mailing address

4107 Medical Pkwy Ste 208
Austin, TX 78756-3729
Phone (512) 980-9861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2020 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP12206TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1033464326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 MEDICAL PKWY STE 208",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563729",
            "telephone_number": "512-980-9861",
            "fax_number": "512-599-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 MEDICAL PKWY STE 208",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563729",
            "telephone_number": "512-980-9861",
            "fax_number": "512-599-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETTI",
        "first_name": "LAUREN",
        "middle_name": "JOHNSTON",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP12206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.