Individual provider Active NPI

Parkerson Michael Laville

  • Student in an Organized Health Care Education/Training Program
  • Conroe, TX
National Provider Identifier
1386348308
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
925 City Central Ave
Conroe, TX 77304-2981
Phone
(936) 202-5202
NPI assigned
Mar 27, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

925 City Central Ave
Conroe, TX 77304-2981

Mailing address

21411 Fossil Trails Dr
Spring, TX 77388-7525
Phone (281) 825-8981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250527001061 TX Order and Referring Only - Family PracticePractitioner - Family Practice 6305365073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: parkerson.laville.1@31617.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1386348308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21411 FOSSIL TRAILS DR",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773887525",
            "telephone_number": "281-825-8981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 CITY CENTRAL AVE",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042981",
            "telephone_number": "936-202-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVILLE",
        "first_name": "PARKERSON",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.