Individual provider Active NPI

Lara Aboulhosn, MD

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
National Provider Identifier
1134489396
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2016-00462 Issued in NC
Practice address
1918 Randolph Rd
Suite 670
Charlotte, NC 28207-1100
Phone
(704) 384-1620
Fax
(704) 384-1626
NPI assigned
May 22, 2012
Last updated
Oct 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 183178 NC
Obstetrics & Gynecology Physician 207V00000X 2016-00462 NC Primary

Addresses

Primary practice location

1918 Randolph Rd
Suite 670
Charlotte, NC 28207-1100

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-7840

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address laboulhosn332676@direct.novanthealth.org

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

State licenses

LicenseStateTypeSpecialty
183178NCMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: laboulhosn332676@direct.novanthealth.org

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1134489396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD",
            "address_2": "SUITE 670",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071100",
            "telephone_number": "704-384-1620",
            "fax_number": "704-384-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOULHOSN",
        "first_name": "LARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-22",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "183178",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2016-00462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laboulhosn332676@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1918 Randolph Rd",
            "address_2": "Suite 670",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; 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.