Individual provider Active NPI

Laura Anne Bertrand, M.D.

  • Urology Physician
  • Newport, KY
National Provider Identifier
1104997238
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
50179 Issued in KY
Practice address
1400 Grand Ave
Newport, KY 41071-2570
Phone
(859) 757-2141
Fax
(859) 441-1348
NPI assigned
Nov 12, 2006
Last updated
Apr 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 50179 KY Primary

Addresses

Primary practice location

1400 Grand Ave
Newport, KY 41071-2570

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 212-0497

Other practice location 1

7370 Turfway Rd
Florence, KY 41042-4895
Phone (859) 212-0497

Other identifiers 3

IdentifierTypeStateIssuer
0232170MedicaidOH
7100490940MedicaidKY
300009058MedicaidIN

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
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1104997238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-212-0497",
            "fax_number": "859-282-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 GRAND AVE",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410712570",
            "telephone_number": "859-757-2141",
            "fax_number": "859-441-1348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7370 Turfway Rd",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410424895",
            "country_code": "US",
            "telephone_number": "859-212-0497",
            "fax_number": "859-212-1141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTRAND",
        "first_name": "LAURA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-12",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KY",
            "license": "50179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0232170",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100490940",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300009058",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.