Individual provider Active NPI

Mickelina Lafleur Laurore

  • Family Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1275908006
Registry record updated Dec 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024173066 Issued in VA
Practice address
4600 Spotsylvania Pkwy
Fredericksburg, VA 22408-7762
Phone
(540) 834-1500
NPI assigned
Dec 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 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 0024173066 VA Primary

Addresses

Primary practice location

4600 Spotsylvania Pkwy
Fredericksburg, VA 22408-7762

Mailing address

1010 W Kensington Cir
Fredericksburg, VA 22401-8003
Phone (239) 691-5450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20160222001884 VA Practitioner - Nurse Practitioner 2668777194 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pedsplus Urgent Care, LLC CurrentSince Nov 20, 2016 Accepting new patients
Stafford Urgent Care, Inc. CurrentSince Apr 16, 2016 Accepting new patients
Centercare Family Practice, LLC CurrentSince Nov 20, 2016 Accepting new patients

Locations

15521 Real Estate Ave
King George, VA 22485
Phone (540) 289-2273

15521 Real Estate Ave
Fl 1
King George, VA 22485

422 Garrisonville Rd
Ste 111
Stafford, VA 22554
Phone (540) 657-9441

Organizations & group practices 3

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": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1275908006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 W KENSINGTON CIR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224018003",
            "telephone_number": "239-691-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 SPOTSYLVANIA PKWY",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224087762",
            "telephone_number": "540-834-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURORE",
        "first_name": "MICKELINA",
        "middle_name": "LAFLEUR",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-04",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.