Individual provider Active NPI

Lara Lee Devero-Williams, APRN

  • Family Nurse Practitioner
  • Winter Haven, FL
National Provider Identifier
1376012385
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F11180234 Issued in FL
Practice address
635 1St St N
Winter Haven, FL 33881-4129
Phone
(863) 294-0670
Fax
(863) 229-7620
NPI assigned
Nov 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F11180234 FL Primary

Addresses

Primary practice location

635 1St St N
Winter Haven, FL 33881-4129

Mailing address

2995 Drew St
Clearwater, FL 33759-3012
Phone (727) 315-7496

Other practice location 1

2200 Osprey Blvd
Bartow, FL 33830-3308
Phone (863) 528-0931

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Laura.Devero-WilliamsAPRN@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

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
I20190416001242 FL Practitioner - Nurse Practitioner 3072854207 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F11180234FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince Dec 2, 2023 Accepting new patients
Baycare Medical Group, Inc CurrentSince Dec 2, 2023 Accepting new patients
Gessler Clinic Professional Association CurrentSince Mar 18, 2019 Accepting new patients
Baycare Medical Group, Inc. Current Accepting new patients

Locations

2200 Osprey Blvd
Bartow, FL 33830
Phone (863) 519-1402

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2995 Drew St
Clearwater, FL 33759
Phone (727) 315-7496

635 1st St N
Winter Haven, FL 33881
Phone (863) 294-0670

601 1st St N
Winter Haven, FL 33881
Phone (863) 294-0670

Interoperability endpoints

  • Direct secure messaging: laura.devero-williamsaprn@direct.mybaycare.org

Organizations & group practices 4

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": "1542585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1376012385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-315-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 1ST ST N",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814129",
            "telephone_number": "863-294-0670",
            "fax_number": "863-229-7620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2200 Osprey Blvd",
            "address_purpose": "LOCATION",
            "city": "Bartow",
            "state": "FL",
            "postal_code": "338303308",
            "country_code": "US",
            "telephone_number": "863-528-0931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVERO-WILLIAMS",
        "first_name": "LARA",
        "middle_name": "LEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-19",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F11180234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Laura.Devero-WilliamsAPRN@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2200 Osprey Blvd",
            "city": "Bartow",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338303308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.