Individual provider Active NPI

Laura Vita Kohtio-Graves, ANP-BC, GNP-BC

  • Adult Health Nurse Practitioner
  • Nantucket, MA
National Provider Identifier
1366620692
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
258804 Issued in MA
Practice address
57 Prospect St
Nantucket, MA 02554-2799
Phone
(508) 228-4846
NPI assigned
Feb 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 258804 MA Primary
Gerontology Nurse Practitioner 363LG0600X 258804 MA

Addresses

Primary practice location

57 Prospect St
Nantucket, MA 02554-2799

Mailing address

57 Prospect St
Nantucket, MA 02554-2799
Phone (508) 228-4846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160303000653 MA Order and Referring Only - Nurse Practitioner 1951607829

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
258804MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nantucket Cottage Hospital Current Accepting new patients
L and L Medical LLC Current Accepting new patients
Nantucket Cottage Hospital Past Accepting new patients

Locations

57 Prospect St
Nantucket, MA 02554
Phone (508) 228-1200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HAEAAA/Endpoint/HAEAAA
  • Direct secure messaging: kohtio-graves.laura.nch@direct.partners.masshiway.net

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": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202428800000",
    "number": "1366620692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 PROSPECT ST",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025542799",
            "telephone_number": "508-228-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 PROSPECT ST",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025542799",
            "telephone_number": "508-228-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHTIO-GRAVES",
        "first_name": "LAURA",
        "middle_name": "VITA",
        "name_prefix": "Mrs.",
        "credential": "ANP-BC, GNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-08",
        "last_updated": "2008-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "258804",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "258804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nantucket, MA

Sources for this page

Verify at the official NPI Registry.