Individual provider Active NPI

Kinsie Lassauw, MSN, FNP-C

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1366033409
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-151309 Issued in AL
Practice address
201 Governors Dr SW
Huntsville, AL 35801-5170
Phone
(256) 265-7246
NPI assigned
Feb 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-151309 AL
Family Nurse Practitioner 363LF0000X 1-151309 AL Primary

Addresses

Primary practice location

201 Governors Dr SW
Huntsville, AL 35801-5170

Mailing address

201 Governors Dr SW
Huntsville, AL 35801-5170
Phone (256) 265-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210212001387 AL Practitioner - Nurse Practitioner 0840605481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Tennessee Valley Pain CenterGroup PAC ID 4587075783, 33 clinicians

Practice addresses (Care Compare)

201 Governors Dr SW
Suite 400
Huntsville, AL 35801-5183
Phone (256) 265-7246

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
  • Athens Limestone Hospital Hospital, Athens, AL, CCN 010079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
1-151309ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
QC Wellness, LLC Current Accepting new patients
Quick Care Urgent, LLC CurrentSince Sep 15, 2021 Accepting new patients
HH Tennessee Valley Pain Center CurrentSince Jun 26, 2023 Accepting new patients
Tennessee Valley Pain Consultants, PC Past Accepting new patients
Quickcare RX LLC PastSince Sep 15, 2021 Accepting new patients

Locations

201 Governors Dr SW
Ste 400
Huntsville, AL 35801
Phone (256) 265-7246

202 Governors Dr SE
Huntsville, AL 35801
Phone (256) 517-8317

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1366033409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 GOVERNORS DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015170",
            "telephone_number": "256-265-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 GOVERNORS DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015170",
            "telephone_number": "256-265-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASSAUW",
        "first_name": "KINSIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-151309",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-151309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.