Individual provider Active NPI

Laura Severyn

  • Family Nurse Practitioner
  • Naples, FL
National Provider Identifier
1366800468
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11013340 Issued in FL
Practice address
12655 Collier Blvd
Naples, FL 34116-4005
Phone
(239) 658-3000
NPI assigned
Feb 3, 2016
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11013340 FL
Family Nurse Practitioner 363LF0000X 11013340 FL Primary
Registered Nurse 163W00000X RN9455603 FL

Addresses

Primary practice location

12655 Collier Blvd
Naples, FL 34116-4005

Mailing address

1168 Goodlette-Frank Rd N
Naples, FL 34102-5451

Other practice location 1

1845 Veterans Park Dr
Naples, FL 34109-0493
Phone (239) 658-3000

Other practice location 2

6101 Pine Ridge Rd
Naples, FL 34119-3900
Phone (239) 348-4000

Other practice location 3

2355 Stanford Ct # 701
Naples, FL 34112-4813
Phone (239) 658-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210816004010 FL Practitioner - Nurse Practitioner 8729483680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Collier Health Services, IncGroup PAC ID 4183521925, 29 clinicians

Practice addresses (Care Compare)

1454 Madison Ave W
Immokalee, FL 34142-2200
Phone (239) 658-3064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9455603FLMDRegistered Nurse
11013340FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Collier Health Services, Inc CurrentSince Jun 20, 2023 Accepting new patients
Collier Health Services Inc CurrentSince Jun 20, 2023 Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services, Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients
Collier Health Services Inc Past Accepting new patients

Locations

125 Boston Ave
Immokalee, FL 34142
Phone (239) 657-5800

1441 Heritage Blvd
Immokalee, FL 34142
Phone (239) 624-8050

1454 Madison Ave W
Immokalee, FL 34142
Phone (239) 658-3064

508 N 9th St
Unit 142
Immokalee, FL 34142
Phone (239) 657-6363

1265 Creekside Pkwy
Ste 206
Naples, FL 34108
Phone (239) 591-2125

12655 Collier Blvd
Naples, FL 34116
Phone (239) 571-9015

1845 Veterans Park Dr
Naples, FL 34109
Phone (239) 571-9015

2355 Stanford Ct
#701
Naples, FL 34112
Phone (239) 244-1356

2355 Stanford Ct
Ste 701
Naples, FL 34112

Interoperability endpoints

  • Direct secure messaging: laura.severyn.1@10865.direct.athenahealth.com

Organizations & group practices 34

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.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1366800468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1168 GOODLETTE-FRANK RD N",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 COLLIER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341164005",
            "telephone_number": "239-658-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 Veterans Park Dr",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341090493",
            "country_code": "US",
            "telephone_number": "239-658-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6101 Pine Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341193900",
            "country_code": "US",
            "telephone_number": "239-348-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2355 Stanford Ct # 701",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341124813",
            "country_code": "US",
            "telephone_number": "239-658-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEVERYN",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-03",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11013340",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11013340",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9455603",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.