Individual provider Active NPI

Laconya Robertson, RN, FNP

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1235521964
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP127638 Issued in TX
Practice address
2113 E Martin Luther King Jr Blvd
Suite 101
Austin, TX 78702-1357
Phone
(512) 391-9700
NPI assigned
Mar 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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 AP127638 TX Primary

Addresses

Primary practice location

2113 E Martin Luther King Jr Blvd
Suite 101
Austin, TX 78702-1357

Mailing address

2113 E Martin Luther King Jr Blvd
Suite 101
Austin, TX 78702-1357
Phone (512) 391-9700

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
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP127638TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1425427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1235521964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2113 E MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787021357",
            "telephone_number": "512-391-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2113 E MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787021357",
            "telephone_number": "512-391-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "LACONYA",
        "name_prefix": "Ms.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-04",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP127638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2015; 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.