Lauren Dewalt, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

95006348 Issued in CA

Practice address

3800 Kilroy Airport Way Ste 100
Long Beach, CA 90806-6818

Phone

(562) 527-7600

NPI assigned

Mar 30, 2016

Last updated

Jan 27, 2022By the provider in NPPES

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

Enrolled in CA, AZ, NV3 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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pine Park Health, IncGroup PAC ID 0345670527, 21 clinicians

Geriatric Specialty Care of Nevada, PLLC, Steven L. Phillips, M.D.Group PAC ID 6901969518, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21048/brand/1/csg/1/fhir/r4
• Direct secure messaging: lauren.dewalt@299395540647940.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pine Park Health, Inc

  • Internal Medicine Physician
  • Berkeley, CA
  • NPI 1346879848

  Adult Health, AZ

  Medicare reassignment Care Compare group NPD
• Geriatric Specialty Care of Nevada, PLLC, Steven L. Phillips, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Reno, NV
  • NPI 1205088838
  Medicare reassignment Care Compare group NPD
• Imran Sharief, M.D., Inc.

  • Multi-Specialty Clinic/Center
  • Tustin, CA
  • NPI 1396906095
  NPD (past)
• KSK Enterprises LLC

  dba American Sleep Medicine

  • Sleep Disorder Diagnostic Clinic/Center
  • Santa Ana, CA
  • NPI 1689694457
  NPD (past)

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1346603248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 E BLUE BIRD AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928691918",
            "telephone_number": "949-293-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 KILROY AIRPORT WAY STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908066818",
            "telephone_number": "562-527-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWALT",
        "first_name": "LAUREN",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-30",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "95006348",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "835264",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruthann Devera, M.D.
• Julia Grace Devere
• Diana Devereaux
• Kirsten Michelle Devin, M.D.
• Carmen Devore, L.AC.
• Kinnari Dewangan
• Cassandra Whitney Dewey
• Eric Dewhirst, RPT
• Seper Dezfoli, M.D.
• DG Medical Imaging

• Adult Health Nurse Practitioner in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.