Individual provider Active NPI

Laura J Zoellner, MD

  • Obstetrics & Gynecology Physician
  • Meridian, ID
National Provider Identifier
1154304558
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
M8106 Issued in ID
Practice address
520 S Eagle Rd
#2207
Meridian, ID 83642-6354
Phone
(208) 288-0989
Fax
(208) 288-0976
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X M8106 ID Primary

Addresses

Primary practice location

520 S Eagle Rd
#2207
Meridian, ID 83642-6354

Mailing address

520 S Eagle Rd
Suite 2207
Meridian, ID 83642-6354
Phone (208) 288-0989

Other identifiers 2

IdentifierTypeStateIssuer
000010139256OtherBS
50427OtherBC

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
30716COMDLicensed Practical Nurse
M8106IDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
OB-GYN Affiliates Obstetrics & Gynecology PastSince Jan 1, 2000 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154304558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD",
            "address_2": "SUITE 2207",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426354",
            "telephone_number": "208-288-0989",
            "fax_number": "208-288-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD",
            "address_2": "#2207",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426354",
            "telephone_number": "208-288-0989",
            "fax_number": "208-288-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOELLNER",
        "first_name": "LAURA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M8106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "000010139256",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "50427",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.