Individual provider Active NPI

Lawanda S Fantroy

  • Acute Care Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1093272874
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-122621 Issued in AL
Practice address
1700 Spring Hill Ave Ste 100
Mobile, AL 36604-1416
Phone
(251) 435-1200
NPI assigned
Feb 27, 2019
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-122621 AL Primary
Adult Health Nurse Practitioner 363LA2200X 20629 MN

Addresses

Primary practice location

1700 Spring Hill Ave Ste 100
Mobile, AL 36604-1416

Mailing address

4361 Terrace Dr
Moss Point, MS 39563-5635
Phone (228) 235-6015

Other practice location 1

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MN, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20190410002927 AL Practitioner - Nurse Practitioner 2264773787 Reassigns benefits to 1 organization
I20240227002804 MN Practitioner - Nurse Practitioner 2264773787 Reassigns benefits to 2 organizations
I20260402000419 TX Practitioner - Nurse Practitioner 2264773787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Imc-Diagnostic and Medical Clinic LLCGroup PAC ID 2860399623, 168 clinicians
H and W Sleep PLLC Dba Frontier Sleep and WellnessGroup PAC ID 9335628825, 4 clinicians

Practice addresses (Care Compare)

1700 Springhill Ave
Suite 100
Mobile, AL 36604-1416
Phone (251) 435-1200

4009 Banister LN
Suite 370
Austin, TX 78704-7040
Phone 5122154350402

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20629MNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Feb 26, 2024 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Mar 4, 2019 Accepting new patients
Allina Health System Current Accepting new patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Mar 4, 2019 Accepting new patients
Gem Health Specialty Sleep Services PA CurrentSince Jun 29, 2025 Accepting new patients
Gem Health Specialty Sleep Services PA CurrentSince Jun 29, 2025 Accepting new patients
Allina Health System CurrentSince Feb 26, 2024 Accepting new patients
Cardio-Pulmonary Rehabilitation (C.P.R.) Acute Care PastSince Oct 4, 2021 Accepting new patients

Locations

1700 Spring Hill Ave
Ste 100
Mobile, AL 36604

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2214 5th St
Ste 5
White Bear Lake, MN 55110
Phone (612) 462-6222

Interoperability endpoints

  • Direct secure messaging: lawanda.fantroy@398008301912068.direct.elationemr.com

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1093272874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 TERRACE DR",
            "city": "MOSS POINT",
            "state": "MS",
            "postal_code": "395635635",
            "telephone_number": "228-235-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SPRING HILL AVE STE 100",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366041416",
            "telephone_number": "251-435-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2925 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554071321",
            "country_code": "US",
            "telephone_number": "612-262-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANTROY",
        "first_name": "LAWANDA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-122621",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "20629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.