Lara Lyn Nelson, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11004624 Issued in FL

Practice address

1066 SW Gatlin Blvd
Port St. Lucie, FL 34953

Phone

(772) 879-8080

Fax

(772) 424-9347

NPI assigned

Apr 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Lara Lyn Nelson-Johnson Former name

Medicare fee-for-service enrollment

Enrolled in SC, TN, FL3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Back in Action Medical Center LLCGroup PAC ID 7810272473, 12 clinicians

Cardiac Vision LLCGroup PAC ID 9032349733, 66 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GCBABD

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.

• Back in Action Medical Center LLC

  • General Practice Physician
  • Palm City, FL
  • NPI 1093183733
  Medicare reassignment Care Compare group NPD
• Cardiac Vision LLC

  • Cardiovascular Disease Physician
  • Jacksonville, FL
  • NPI 1144651373
  Medicare reassignment Care Compare group NPD
• Back in Action Medical Center LLC

  • Rehabilitation Clinic/Center
  • Palm City, FL
  • NPI 1225592603
  NPD
• Shaw Medical Group LLC

  dba MyHealth by Shaw Medical Group

  • Family Medicine Physician
  • Barefoot Bay, FL
  • NPI 1255884938
  NPD (past)

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1346414745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 SW MARTIN HWY",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349903222",
            "telephone_number": "772-324-9337",
            "fax_number": "772-324-9347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 SW GATLIN BLVD",
            "city": "PORT ST. LUCIE",
            "state": "FL",
            "postal_code": "34953",
            "telephone_number": "772-879-8080",
            "fax_number": "772-424-9347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2351 SW Martin Hwy",
            "address_purpose": "LOCATION",
            "city": "Palm City",
            "state": "FL",
            "postal_code": "349903222",
            "country_code": "US",
            "telephone_number": "772-324-9337",
            "fax_number": "772-324-9347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "LARA",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2024-05-08",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "25042",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "33103",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11004624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "NELSON-JOHNSON",
            "middle_name": "LYN",
            "prefix": "MRS.",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nelaj Solutions (Listening Waves Therapy Solutions)
• Nelisha Family Home LLC
• Barrington L Nelson M D
• Abby Nelson
• Janile Nelson, APRN
• Lisa Nelson, PA-C
• Paul John Nelson Jr., RBT
• Tiella Nembhard
• Neuropsych Solutions LLC
• Neuroscience and Sleep Disorders Center

• Family Nurse Practitioner in Port St. Lucie, FL
• Providers in Port St. Lucie, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.