Active NPI
Laura W Bastian
- Registered Nurse
- Rocky Mount, NC
National Provider Identifier
1114706686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 147408
- Practice address
- 4008 Capital Dr
Rocky Mount, NC 27804-3123 - Phone
- (252) 937-5003
- NPI assigned
- Sep 25, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 147408 | NC | Primary |
Addresses
Primary practice location
4008 Capital Dr
Rocky Mount, NC 27804-3123
Mailing address
1821 Erkin Smith Rd
Nashville, NC 27856-8805
Phone (252) 904-1639
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147408 | NC | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Plastic Surgery, P.a. | Current | Accepting new patients |
Locations
4008 Capital Dr
Rocky Mount, NC 27804
Phone (252) 937-5003
Organizations & group practices 1
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.
-
- Specialist
- Rocky Mount, NC
- NPI 1265533806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1114706686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1821 ERKIN SMITH RD",
"city": "NASHVILLE",
"state": "NC",
"postal_code": "278568805",
"telephone_number": "252-904-1639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4008 CAPITAL DR",
"city": "ROCKY MOUNT",
"state": "NC",
"postal_code": "278043123",
"telephone_number": "252-937-5003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASTIAN",
"first_name": "LAURA",
"middle_name": "W",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-25",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "147408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rocky Mount, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.