Organization Active NPI

Shaun E Laurie Professional Association

  • Internal Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1396788626
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SHAUN E LAURIE PROFESSIONAL ASSOCIATION
Practice address
1628 N Plaza Dr
Tallahassee, FL 32308-2300
Phone
(850) 309-1331
Fax
(850) 309-1332
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Authorized official

Name
Dr. Shaun E LaurieNPI 1952344285
Title
President
Phone
(850) 309-1331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1628 N Plaza Dr
Tallahassee, FL 32308-2300

Mailing address

1628 N Plaza Dr
Tallahassee, FL 32308-2300
Phone (850) 309-1331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060126000273 FL Part B Supplier - Clinic/Group Practice 3173537438 Receives reassigned benefits from 2 practitioners
Practice locations: Tallahassee, FL

National Provider Directory

National Provider Directory

Locations

13455 W US 90
Greenville, FL 32331
Phone (800) 708-4008

3101 Ginger Dr
Tallahassee, FL 32308
Phone (850) 877-2177

2711 Capital Medical Blvd
Ste 100A
Tallahassee, FL 32308
Phone (850) 309-1331

1628 N Plaza Dr
Tallahassee, FL 32308
Phone (850) 309-1331

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1396788626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 N PLAZA DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323082300",
            "telephone_number": "850-309-1331",
            "fax_number": "850-309-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 N PLAZA DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323082300",
            "telephone_number": "850-309-1331",
            "fax_number": "850-309-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAUN E LAURIE PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "LAURIE",
        "authorized_official_first_name": "SHAUN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-309-1331",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.