Individual provider Active NPI

Gale Estelle Laidlaw, FNP-C

  • Family Nurse Practitioner
  • Montclair, CA
National Provider Identifier
1396137329
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95000673 Issued in CA
Practice address
8891 Central Ave
Montclair, CA 91763-1618
Phone
(909) 256-6986
NPI assigned
Feb 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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 NP95000673 CA Primary

Addresses

Primary practice location

8891 Central Ave
Montclair, CA 91763-1618

Mailing address

834 S Calmgrove Ave
Glendora, CA 91740-4822
Phone (714) 369-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180504001732 CA Practitioner - Nurse Practitioner 5698039311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Urgent Care, Inc.Group PAC ID 4981992807, 4 clinicians

Practice addresses (Care Compare)

148 N Grand Ave
Glendora, CA 91741-2434
Phone (626) 594-0478

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95000673CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Urgent Care, Inc. CurrentSince Mar 26, 2018 Accepting new patients

Locations

148 N Grand Ave
Glendora, CA 91741
Phone (626) 594-0478

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1396137329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 S CALMGROVE AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404822",
            "telephone_number": "714-369-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8891 CENTRAL AVE",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917631618",
            "telephone_number": "909-256-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIDLAW",
        "first_name": "GALE",
        "middle_name": "ESTELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-27",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95000673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

Verify at the official NPI Registry.