Individual provider Active NPI

Laura Elizabeth Anissian, MD

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1194989244
Registry record updated Jun 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
202268 Issued in LA
Practice address
508 S Habana Ave Ste 220
Tampa, FL 33609-4161
Phone
(813) 870-0207
Fax
(813) 441-7975
NPI assigned
Jul 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 202268 LA Primary

Addresses

Primary practice location

508 S Habana Ave Ste 220
Tampa, FL 33609-4161

Mailing address

1453 E Bert Kouns Industrial Loop
Ste 221
Shreveport, LA 71105-5634
Phone (318) 795-4766

Other identifiers 1

IdentifierTypeStateIssuer
1362697MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170619001396 OR Practitioner - Internal Medicine 1557439767 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
202268LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Wellness LLC Internal Medicine Current Accepting new patients
Legacy Meridian Park Hospital CurrentSince Jul 17, 2017 Accepting new patients
Legacy Meridian Park Hospital CurrentSince Jul 17, 2017 Accepting new patients
Saint Francis Medical Center Internal Medicine Past Accepting new patients
John P. Lippelman MD PA PastSince Jul 12, 2010 Accepting new patients

Locations

508 S Habana Ave
Ste 220
Tampa, FL 33609
Phone (813) 870-0207

18010 SW McEwan Rd
Lake Oswego, OR 97035
Phone (503) 525-7500

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

Organizations & group practices 5

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": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781308800000",
    "number": "1194989244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP",
            "address_2": "STE 221",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055634",
            "telephone_number": "318-795-4766",
            "fax_number": "318-795-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S HABANA AVE STE 220",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094161",
            "telephone_number": "813-870-0207",
            "fax_number": "813-441-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANISSIAN",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2026-06-13",
        "certification_date": "2026-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "202268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1362697",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.