Individual provider Active NPI

Laura Ann Previll, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Durham, NC
National Provider Identifier
1275890568
Registry record updated Jan 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
2016-01222 Issued in NC
Practice address
508 Fulton St
Durham, NC 27705-3875
Phone
(919) 286-6932
Fax
(919) 286-6823
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2016-01222 NC Primary

Addresses

Primary practice location

508 Fulton St
Durham, NC 27705-3875

Mailing address

508 Fulton Street
Grecc Mail Stop 182
Durham, NC 27705
Phone (216) 401-6796

Other practice location 1

4220 N Roxboro St
Durham, NC 27704-1826
Phone (919) 620-4070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240215000229 NC Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 8426377904

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016-01222NCMDGeriatric Medicine (Internal Medicine) Physician

Interoperability endpoints

  • Direct secure messaging: lprevill275352@direct.medicine.duke.edu

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674950400000",
    "number": "1275890568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 FULTON STREET",
            "address_2": "GRECC MAIL STOP 182",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27705",
            "telephone_number": "216-401-6796",
            "fax_number": "919-471-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 FULTON ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277053875",
            "telephone_number": "919-286-6932",
            "fax_number": "919-286-6823"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4220 N Roxboro St",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277041826",
            "country_code": "US",
            "telephone_number": "919-620-4070",
            "fax_number": "919-471-3624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PREVILL",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2023-01-29",
        "certification_date": "2023-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "2016-01222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.