Individual provider Active NPI

Laurisa Ann Webster, MD

  • Family Medicine Physician
  • Hayden, ID
National Provider Identifier
1205247269
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M13747 Issued in ID
Practice address
8181 N Cornerstone Dr
Hayden, ID 83835-8752
Phone
(208) 772-0785
Fax
(208) 762-2704
NPI assigned
May 13, 2014
Last updated
Apr 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M13747 ID Primary

Addresses

Primary practice location

8181 N Cornerstone Dr
Hayden, ID 83835-8752

Mailing address

8181 N Cornerstone Dr
Hayden, ID 83835-8752
Phone (208) 772-0785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20170713002734 ID Practitioner - Family PracticePractitioner - Hospitalist 8123344090 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Professional AssociatesGroup PAC ID 6305812017, 8 clinicians

Practice addresses (Care Compare)

8181 N Cornerstone Dr
Hayden Lake, ID 83835-8752
Phone (208) 772-0785

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M13747IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Professional Associates Family Medicine CurrentSince Jul 1, 2017 Accepting new patients

Locations

8181 N Cornerstone Dr
Hayden Lake, ID 83835
Phone (208) 772-0785

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1205247269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8181 N CORNERSTONE DR",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358752",
            "telephone_number": "208-772-0785",
            "fax_number": "208-762-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8181 N CORNERSTONE DR",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358752",
            "telephone_number": "208-772-0785",
            "fax_number": "208-762-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "LAURISA",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M13747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

Verify at the official NPI Registry.