Active NPI
Eileen I Lawson, PAC
- Physician Assistant
- St. Mary's, AK
National Provider Identifier
1366431496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 103088
- Practice address
- 310 High School Road
St. Mary's, AK 99658 - Phone
- (907) 438-3517
- NPI assigned
- Oct 20, 2005
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 103088 | NC | Primary |
Addresses
Primary practice location
310 High School Road
St. Mary's, AK 99658
Mailing address
9474 Hwy 111
Anacoco, LA 71403-4423
Phone (910) 309-7325
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P18033 | Medicaid | NC |
Other names 1
- Eileen M Santos
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103088 | NC | MD | Physician Assistant |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1366431496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9474 HWY 111",
"city": "ANACOCO",
"state": "LA",
"postal_code": "714034423",
"telephone_number": "910-309-7325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 HIGH SCHOOL ROAD",
"city": "ST. MARY'S",
"state": "AK",
"postal_code": "99658",
"telephone_number": "907-438-3517"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWSON",
"first_name": "EILEEN",
"middle_name": "I",
"name_prefix": "Mrs.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "103088",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "P18033",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EILEEN",
"last_name": "SANTOS",
"middle_name": "M",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in St. Mary's, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.