Active NPI
Laura Leigh Walsh, PA
- Medical Physician Assistant
- Vero Beach, FL
National Provider Identifier
1053436139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9104112
- Practice address
- 1880 37TH St
Suite 4
Vero Beach, FL 32960-6591 - Phone
- (772) 778-1400
- Fax
- (772) 778-4626
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9104112 | FL | Primary |
Addresses
Primary practice location
1880 37TH St
Suite 4
Vero Beach, FL 32960-6591
Mailing address
1880 37TH St
Suite 4
Vero Beach, FL 32960-6591
Phone (772) 778-1400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA9104112 | Other | FL | STATE LICENSE NUMBER |
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sabal Palm Emergency Physicians | Past | Accepting new patients | |
| Town & Country Emergency Physicians LLC | Past | Accepting new patients | |
| Quality Drive Emergency Physicians LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Spring Hill, FL
- NPI 1093998833
-
- Emergency Medicine Physician
- Dade City, FL
- NPI 1205023595
-
- Emergency Medicine Physician
- Tampa, FL
- NPI 1629024088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053436139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1880 37TH ST",
"address_2": "SUITE 4",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329606591",
"telephone_number": "772-778-1400",
"fax_number": "772-778-4626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1880 37TH ST",
"address_2": "SUITE 4",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329606591",
"telephone_number": "772-778-1400",
"fax_number": "772-778-4626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "LAURA",
"middle_name": "LEIGH",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9104112",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "PA9104112",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.