Nicole Teresa Lawrence, M.D

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

ME111073 Issued in FL

Practice address

23 Mack Bayou Loop Ste 100
Santa Rosa Beach, FL 32459-2606

Phone

(850) 416-1575

NPI assigned

Jul 26, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1217030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1326203589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-475-4686",
            "fax_number": "850-475-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MACK BAYOU LOOP STE 100",
            "city": "SANTA ROSA BEACH",
            "state": "FL",
            "postal_code": "324592606",
            "telephone_number": "850-416-1575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5153 N 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048785",
            "country_code": "US",
            "telephone_number": "850-505-4760",
            "fax_number": "850-505-4711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5153 N 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048785",
            "country_code": "US",
            "telephone_number": "850-505-4760",
            "fax_number": "850-505-4711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "NICOLE",
        "middle_name": "TERESA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME111073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Gastroenterology Physician in Santa Rosa Beach, FL
• Providers in Santa Rosa Beach, FL by specialty
• Pediatric Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.