Individual provider Active NPI

Lauren Laird

  • Physical Therapist
  • Fishers, IN
National Provider Identifier
1063845238
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05010863A Issued in IN
Practice address
11650 Lantern Rd
Suite 235
Fishers, IN 46038-2993
Phone
(317) 576-8410
NPI assigned
Aug 12, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05010863A IN Primary

Addresses

Primary practice location

11650 Lantern Rd
Suite 235
Fishers, IN 46038-2993

Mailing address

11650 Lantern Rd
Suite 235
Fishers, IN 46038-2993
Phone (317) 576-8410

Other identifiers 1

IdentifierTypeStateIssuer
05010863AOtherINPHYSICAL THERAPY LIOENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230609001191 IN Practitioner - Physical Therapist in Private Practice 7416314281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Creative Health Care Management LLCGroup PAC ID 4385929892, 87 clinicians

Practice addresses (Care Compare)

4010 S Ironwood Dr
Vertis Therapy|Grand Emerald
South Bend, IN 46614-2200
Phone (574) 216-4510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
05010863AINMDPhysical Therapist

Organizations & group practices 1

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": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1063845238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 LANTERN RD",
            "address_2": "SUITE 235",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382993",
            "telephone_number": "317-576-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 LANTERN RD",
            "address_2": "SUITE 235",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382993",
            "telephone_number": "317-576-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIRD",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010863A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LIOENSE",
            "identifier": "05010863A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.