Individual provider Active NPI

Daisy Lara, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Kennett Square, PA
National Provider Identifier
1083081772
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP017947 Issued in PA
Practice address
830 West Cypress St
Kennett Square, PA 19348-2218
Phone
(610) 444-8084
NPI assigned
Aug 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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 SP014976 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP017947 PA Primary

Addresses

Primary practice location

830 West Cypress St
Kennett Square, PA 19348-2218

Mailing address

830 West Cypress St
Kennett Square, PA 19348-2218
Phone (610) 444-8084

Other practice location 1

201 Reeceville Rd
Coatesville, PA 19320-1542
Phone (610) 383-8000

Other practice location 2

105 Vineyard Way Ste 200
West Grove, PA 19390-8849
Phone (610) 444-7550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20151002001907 PA Practitioner - Nurse Practitioner 2466760988 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fellowship Health Resources, Inc CurrentSince Mar 17, 2018 Accepting new patients
Human Services, Inc. CurrentSince Oct 15, 2016 Accepting new patients
Bet-El Counseling Services, Inc CurrentSince Dec 16, 2020 Accepting new patients
Human Services, Inc Current Accepting new patients

Locations

1041 W Bridge St
Ste 5
Phoenixville, PA 19460
Phone (610) 415-9301

50 James Buchanan Rd
Thorndale, PA 19372
Phone (610) 200-6222

24 Albion Rd
Ste 420
Lincoln, RI 02865
Phone (401) 333-3980

Organizations & group practices 4

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": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1083081772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 WEST CYPRESS ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482218",
            "telephone_number": "610-444-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 WEST CYPRESS ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482218",
            "telephone_number": "610-444-8084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Reeceville Rd",
            "address_purpose": "LOCATION",
            "city": "Coatesville",
            "state": "PA",
            "postal_code": "193201542",
            "country_code": "US",
            "telephone_number": "610-383-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 Vineyard Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "West Grove",
            "state": "PA",
            "postal_code": "193908849",
            "country_code": "US",
            "telephone_number": "610-444-7550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARA",
        "first_name": "DAISY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP014976",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP017947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennett Square, PA

Sources for this page

Verify at the official NPI Registry.