Active NPI
Lauren Douglas, FNP
- Nurse Practitioner
- Mesa, AZ
National Provider Identifier
1063138204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 284981
- Practice address
- 7525 E Broadway Rd Ste 9
Mesa, AZ 85208-1156 - Phone
- (480) 786-5000
- NPI assigned
- Oct 19, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 284981 | AZ | Primary |
| General Practice Registered Nurse | 163WG0000X | 208245 | AZ |
Addresses
Primary practice location
7525 E Broadway Rd Ste 9
Mesa, AZ 85208-1156
Mailing address
PO Box 20610
Mesa, AZ 85277-0610
Phone (833) 584-1347
Other practice location 1
845 E Warner Rd Ste 101
Chandler, AZ 85225-1058
Phone (480) 786-5000
Other practice location 2
2745 S Alma School Rd Ste 3
Chandler, AZ 85286-4405
Phone (602) 919-0345
Other practice location 3
534 E Sherri Dr
Gilbert, AZ 85296-3830
Phone (602) 653-8776
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 208245 | AZ | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685404800000",
"number": "1063138204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 20610",
"city": "MESA",
"state": "AZ",
"postal_code": "852770610",
"telephone_number": "833-584-1347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7525 E BROADWAY RD STE 9",
"city": "MESA",
"state": "AZ",
"postal_code": "852081156",
"telephone_number": "480-786-5000"
}
],
"practiceLocations": [
{
"address_1": "845 E Warner Rd Ste 101",
"address_purpose": "LOCATION",
"city": "Chandler",
"state": "AZ",
"postal_code": "852251058",
"country_code": "US",
"telephone_number": "480-786-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2745 S Alma School Rd Ste 3",
"address_purpose": "LOCATION",
"city": "Chandler",
"state": "AZ",
"postal_code": "852864405",
"country_code": "US",
"telephone_number": "602-919-0345",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "534 E Sherri Dr",
"address_purpose": "LOCATION",
"city": "Gilbert",
"state": "AZ",
"postal_code": "852963830",
"country_code": "US",
"telephone_number": "602-653-8776",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOUGLAS",
"first_name": "LAUREN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-19",
"last_updated": "2023-05-30",
"certification_date": "2023-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "284981",
"primary": true
},
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "AZ",
"license": "208245",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.