Individual provider Active NPI

Lauren J Threatt, NP

  • Nurse Practitioner
  • Midlothian, VA
National Provider Identifier
1366031387
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024180734 Issued in VA
Practice address
13572 Waterford PL
Midlothian, VA 23112-3928
Phone
(804) 560-8782
NPI assigned
Jan 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024180734 VA Primary

Addresses

Primary practice location

13572 Waterford PL
Midlothian, VA 23112-3928

Mailing address

12331 Hulsey Dr
Chesterfield, VA 23838-2970
Phone (804) 683-0206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20210201001329 VA Practitioner - Nurse Practitioner 5799199857 Reassigns benefits to 3 organizations
I20220204000864 DC Practitioner - Nurse Practitioner 5799199857 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024180734VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Intensivist Services PC CurrentSince Jul 18, 2023 Accepting new patients
Virginia Internal Medicine Inc CurrentSince Dec 26, 2021 Accepting new patients
Cardiology of Virginia, Inc. CurrentSince Jan 27, 2021 Accepting new patients

Locations

9722 Groffs Mill Dr
Owings Mills, MD 21117
Phone (410) 205-9255

9640 Burke Lake Rd
Burke, VA 22015
Phone (347) 761-7200

3440 S Jefferson St
Falls Church, VA 22041
Phone (703) 578-7108

3440 S Jefferson St
#12202
Falls Church, VA 22041
Phone (703) 820-1488

13572 Waterford Pl
Midlothian, VA 23112
Phone (804) 560-8782

1401 Johnston Willis Dr
North Chesterfield, VA 23235
Phone (804) 327-4046

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

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": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1366031387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12331 HULSEY DR",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238382970",
            "telephone_number": "804-683-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13572 WATERFORD PL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231123928",
            "telephone_number": "804-560-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THREATT",
        "first_name": "LAUREN",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024180734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.