Individual provider Active NPI

Laurael Robichaud, PA-C

  • Medical Physician Assistant
  • Butner, NC
National Provider Identifier
1114236593
Registry record updated Oct 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-02538 Issued in NC
Practice address
300 Veazey Dr
Butner, NC 27509-1668
Phone
(919) 764-2619
Fax
(919) 764-2374
NPI assigned
Oct 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-02538 NC Primary

Addresses

Primary practice location

300 Veazey Dr
Butner, NC 27509-1668

Mailing address

300 Veazey Dr
Butner, NC 27509-1668
Phone (919) 764-2619

Other identifiers 1

IdentifierTypeStateIssuer
0010-02538OtherNCMEDICAL BOARD LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1114236593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 VEAZEY DR",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275091668",
            "telephone_number": "919-764-2619",
            "fax_number": "919-764-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 VEAZEY DR",
            "city": "BUTNER",
            "state": "NC",
            "postal_code": "275091668",
            "telephone_number": "919-764-2619",
            "fax_number": "919-764-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBICHAUD",
        "first_name": "LAURAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-02538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD LICENSE",
            "identifier": "0010-02538",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Butner, NC

Sources for this page

Verify at the official NPI Registry.