Individual provider Active NPI

Laura Millener, RN, NP-C

  • Family Nurse Practitioner
  • Emeryville, CA
National Provider Identifier
1194034330
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95010801 Issued in CA
Practice address
1333 Powell St Ste A103
Emeryville, CA 94608
Phone
(415) 658-6791
NPI assigned
Oct 6, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 172835 TN
Family Nurse Practitioner 363LF0000X RN96625 NV
Family Nurse Practitioner 363LF0000X 95010801 CA Primary

Addresses

Primary practice location

1333 Powell St Ste A103
Emeryville, CA 94608

Mailing address

130 Sutter St FL 2
San Francisco, CA 94104-4009
Phone (415) 658-6791

Other practice location 1

2704 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 750-3425

Other practice location 2

2704 N Tenaya Way
Las Vegas, NV 89128-0424
Phone (702) 750-3425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20180112000433 NV Practitioner - Nurse Practitioner 9830418144 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
172835TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, Inc CurrentSince Jan 22, 2018 Accepting new patients

Locations

8680 W Cheyenne Ave
Las Vegas, NV 89129
Phone (702) 750-3425

2704 N Tenaya Way
Las Vegas, NV 89128
Phone (702) 243-8500

2316 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 877-8330

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": "1286323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1194034330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUTTER ST FL 2",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941044009",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 POWELL ST STE A103",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "94608",
            "telephone_number": "415-658-6791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2704 N Tenaya Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280424",
            "country_code": "US",
            "telephone_number": "702-750-3425",
            "fax_number": "702-750-3434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2704 N Tenaya Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280424",
            "country_code": "US",
            "telephone_number": "702-750-3425",
            "fax_number": "702-750-3434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLENER",
        "first_name": "LAURA",
        "credential": "RN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-06",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "172835",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "RN96625",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95010801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emeryville, CA

Sources for this page

Verify at the official NPI Registry.