Laren Paige Deyoung

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1003115 Issued in TX

Practice address

725 Partridge Dr
Fort Worth, TX 76131-8810

Phone

(318) 471-7513

NPI assigned

Jun 5, 2020

Last updated

Nov 14, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605312000000",
    "number": "1336763234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 PARTRIDGE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761318810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 PARTRIDGE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761318810",
            "telephone_number": "318-471-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYOUNG",
        "first_name": "LAREN",
        "middle_name": "PAIGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-11-14",
        "certification_date": "2020-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "989873",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1003115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas N Dewar, M.D.
• Alden Dewey, DO
• Kaci Dewitt-Rickards, D.P.T
• Deyoung Consulting Inc.
• Joseph Mark Deyoung, LMFT
• Zachary Dezeeuw, MD
• DFW Accident and Injury Centers LLC
• DFW Advanced Surgical Care PLLC
• DFW Advanced Surgical Group
• DFW Atlantex LLC

• Pediatric Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2020; 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.