Individual provider Active NPI

Laquinten Peterson, NP

  • Family Nurse Practitioner
  • Bastrop, LA
National Provider Identifier
1154015329
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
229719 Issued in LA
Practice address
323 W Walnut Ave
Bastrop, LA 71220-4521
Phone
(318) 218-6077
NPI assigned
Jun 8, 2023
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 229719 LA Primary

Addresses

Primary practice location

323 W Walnut Ave
Bastrop, LA 71220-4521

Mailing address

PO Box 293
Bastrop, LA 71221-0293
Phone (318) 283-3910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20230831000313 LA Practitioner - Nurse Practitioner 4385007863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morehouse Parish Hospital Service District 1Group PAC ID 6507990165, 7 clinicians

Practice addresses (Care Compare)

323 W Walnut Ave
Bastrop, LA 71220-4521
Phone (318) 283-3910

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
229719LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr James Michael Smith Apmc Current Accepting new patients
Morehouse Parish Hospital Service District 1 Family CurrentSince Jul 1, 2023 Accepting new patients
Morehouse General Hospital Past Accepting new patients

Locations

323 W Walnut Ave
Bastrop, LA 71220
Phone (318) 283-3600

532 S Washington St
Bastrop, LA 71220
Phone (318) 281-5600

8649 Highway 165 N
Ste 1
Monroe, LA 71203
Phone (318) 283-3980

Interoperability endpoints

  • FHIR API: https://fhir.yourcareuniverse.net/tenant/5c9c3d79-6b2c-4465-a5ab-001ebd43fba3
  • Direct secure messaging: laquinten.peterson.1@29430.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1154015329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 293",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712210293",
            "telephone_number": "318-283-3910",
            "fax_number": "318-239-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 W WALNUT AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712204521",
            "telephone_number": "318-218-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "LAQUINTEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "229719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, LA

Sources for this page

Verify at the official NPI Registry.