Individual provider Active NPI

Emilou Camotes Lao, FNP-C

  • Nurse Practitioner
  • Fayetteville, NC
National Provider Identifier
1043042880
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5020681 Issued in NC
Practice address
200 Forsythe St
Fayetteville, NC 28303-5426
Phone
(910) 824-7619
NPI assigned
Aug 19, 2024
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5020681 NC Primary

Addresses

Primary practice location

200 Forsythe St
Fayetteville, NC 28303-5426

Mailing address

PO Box 852
Red Springs, NC 28377-0852
Phone (646) 992-0638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241009001936 NC Practitioner - Nurse Practitioner 7113458563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prana Health PLLCGroup PAC ID 0143519264, 4 clinicians

Practice addresses (Care Compare)

200 Forsythe St
Fayetteville, NC 28303-5426
Phone (910) 824-7619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prana Health PLLC CurrentSince Sep 19, 2024 Accepting new patients
Prana Health PLLC CurrentSince Sep 19, 2024 Accepting new patients

Locations

200 Forsythe St
Fayetteville, NC 28303
Phone (910) 485-0700

1212 Central Dr
Ste 103
Sanford, NC 27330
Phone (910) 824-7619

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": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1043042880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 852",
            "city": "RED SPRINGS",
            "state": "NC",
            "postal_code": "283770852",
            "telephone_number": "646-992-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FORSYTHE ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035426",
            "telephone_number": "910-824-7619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAO",
        "first_name": "EMILOU",
        "middle_name": "CAMOTES",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5020681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.