Individual provider Active NPI

Laura Suzanne Alexander, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1255987335
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
71009402A Issued in IN
Practice address
220 E Virginia St
Evansville, IN 47711-5530
Phone
(812) 777-0127
Fax
(949) 703-7538
NPI assigned
Aug 14, 2019
Last updated
Oct 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71009402A IN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71009402A IN Primary

Addresses

Primary practice location

220 E Virginia St
Evansville, IN 47711-5530

Mailing address

8735 New Harmony Rd
Evansville, IN 47720-8909
Phone (812) 484-5067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20191022001346 IN Practitioner - Nurse Practitioner 6204168487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

220 E Virginia St
Evansville, IN 47711-5530
Phone (812) 777-0127

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71009402AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Authentic Psychiatry & Wellness LLC Psychiatric/Mental Health CurrentSince Sep 1, 2024 Accepting new patients

Locations

120 N Main St
Evansville, IN 47711
Phone (812) 422-6812

220 E Virginia St
Evansville, IN 47711
Phone (812) 431-5983

Interoperability endpoints

  • Direct secure messaging: lstocker57181@direct.deaconess.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1255987335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8735 NEW HARMONY RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477208909",
            "telephone_number": "812-484-5067",
            "fax_number": "949-703-7538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E VIRGINIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477115530",
            "telephone_number": "812-777-0127",
            "fax_number": "949-703-7538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "LAURA",
        "middle_name": "SUZANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009402A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71009402A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.