Individual provider Active NPI

Laura Andraya Way, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Valdosta, GA
National Provider Identifier
1366131401
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN279466 Issued in GA
Practice address
3312 N Oak Street Ext BLDG D
Valdosta, GA 31605-1066
Phone
(229) 244-2030
NPI assigned
May 4, 2023
Last updated
May 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN279466 GA Primary

Addresses

Primary practice location

3312 N Oak Street Ext BLDG D
Valdosta, GA 31605-1066

Mailing address

4120 Midland Ave
Tifton, GA 31794-6149
Phone (229) 326-9557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240104001950 GA Practitioner - Nurse Practitioner 7416308390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ar Psychiatric and Counseling Center LLCGroup PAC ID 9335326941, 11 clinicians

Practice addresses (Care Compare)

3312 N Oak St Ext
BLDG D
Valdosta, GA 31605-1066
Phone (229) 244-2030

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ar Psychiatric & Counseling Center LLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

2014 Pineview Ave
Tifton, GA 31794
Phone (229) 387-8878

3312 N Oak Street Ext
Bldg D
Valdosta, GA 31605
Phone (229) 244-2030

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1366131401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 MIDLAND AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317946149",
            "telephone_number": "229-326-9557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 N OAK STREET EXT BLDG D",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316051066",
            "telephone_number": "229-244-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAY",
        "first_name": "LAURA",
        "middle_name": "ANDRAYA",
        "name_prefix": "Miss",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN279466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.