Individual provider Active NPI

Lauren Douglas, FNP

  • Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1063138204
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
284981 Issued in AZ
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

Updated by the provider on May 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
208245AZMDGeneral 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.

Verify at the official NPI Registry.