Laurel J Robertson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10835 Issued in CT

Practice address

30 Hyde Ave Ste 109
Vernon, CT 06066-4503

Phone

(860) 454-0303

Fax

(860) 875-4242

NPI assigned

Aug 17, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Laurel J Blaschik Other name

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: ms_lrobe152@landmarkhealth-direct.org

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1144948001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HYDE AVE STE 109",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664503",
            "telephone_number": "860-454-0303",
            "fax_number": "860-875-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HYDE AVE STE 109",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060664503",
            "telephone_number": "860-454-0303",
            "fax_number": "860-875-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "LAUREL",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-17",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "10835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREL",
            "last_name": "BLASCHIK",
            "middle_name": "J",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Meghan Elizabeth Robbins, MD
• Robert a. Kiel, D.M.D., LLC
• Robert J. Gange, DDS,Ms,LLC
• Lynn Roberts, PSYD
• Margaret Mary Roberts, PTA
• Paula C Rocha, APRN
• Richard Russell Rock, OD
• Rockville General Hospital, Inc
• Allison E Rodrigue
• Carrie Rogers, OT

• Family Nurse Practitioner in Vernon, CT
• Providers in Vernon, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.