Individual provider Active NPI

Laurice A McCord, PNP-BC

  • Pediatric Nurse Practitioner
  • Maynardville, TN
National Provider Identifier
1134568728
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APN6236 Issued in TN
Practice address
147 Oakland LN
Maynardville, TN 37807-3354
Phone
(659) 929-9778
Fax
(865) 992-1888
NPI assigned
Jun 18, 2013
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X APN6236 TN Primary
Pediatric Registered Nurse 163WP0200X RN0000076081 TN

Addresses

Primary practice location

147 Oakland LN
Maynardville, TN 37807-3354

Mailing address

147 Oakland LN
Maynardville, TN 37807-3354
Phone (865) 992-9977

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN0000076081TNMDPediatric Registered Nurse
APN6236TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Knoxville Neurology Specialists, PLLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1134568728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 OAKLAND LN",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "378073354",
            "telephone_number": "865-992-9977",
            "fax_number": "865-992-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 OAKLAND LN",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "378073354",
            "telephone_number": "659-929-9778",
            "fax_number": "865-992-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORD",
        "first_name": "LAURICE",
        "middle_name": "A",
        "credential": "PNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "APN6236",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TN",
            "license": "RN0000076081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maynardville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.