Individual provider Active NPI

Laura B Fleiner, PA

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1083804405
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005112 Issued in GA
Practice address
4849 Paulsen St Ste 314
Savannah, GA 31405-4426
Phone
(912) 354-3363
Fax
(912) 354-3332
NPI assigned
Aug 1, 2007
Last updated
Aug 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1599 GA
Physician Assistant 363A00000X 005112 GA Primary

Addresses

Primary practice location

4849 Paulsen St Ste 314
Savannah, GA 31405-4426

Mailing address

4849 Paulsen St Ste 314
Savannah, GA 31405-4426
Phone (912) 354-3363

Other identifiers 3

IdentifierTypeStateIssuer
1599OtherGATEMPORARY PERMIT NUMBER
532267996AMedicaidGA
97WCJXHOtherGAMEDICARE

Other names 1

  • Laura E. Fleiner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20070919000079 GA Practitioner - Physician Assistant 8123112380

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1599GAMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1083804405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 PAULSEN ST STE 314",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054426",
            "telephone_number": "912-354-3363",
            "fax_number": "912-354-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 PAULSEN ST STE 314",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054426",
            "telephone_number": "912-354-3363",
            "fax_number": "912-354-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEINER",
        "first_name": "LAURA",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "1599",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEMPORARY PERMIT NUMBER",
            "identifier": "1599",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "532267996A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "97WCJXH",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "FLEINER",
            "middle_name": "E.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.