Lauren Gabrielle Azoury, FNP
Individual provider Active NPI Nurse Practitioner · Farmington, MO
NPI 1407520166 · NPPES record last updated Sep 27, 2021
Key facts
- NPI
- 1407520166
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 2021018076 (MO)
- Practice address
- 1103 W Liberty St Ste 4050C
Farmington, MO 63640-1921 - Phone
- (573) 760-8253
- NPI assigned
- Aug 5, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211004000387 | MO | Practitioner - Nurse Practitioner | 3476951641 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021018076 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physician Groups LC | Current |
Accepting new patients | |
| Parkland Health Center | Current |
Accepting new patients | |
| Parkland Health Center | Current |
Accepting new patients |
Locations
1101 W Liberty St
Farmington, MO 63640
Phone (573) 705-1272
301 N Washington St
Ste 5
Farmington, MO 63640
Phone (573) 756-1744
1103 W Liberty St
Farmington, MO 63640
Phone (573) 760-8488
1103 W Liberty St
Ste 4050C
Farmington, MO 63640
Phone (573) 760-8253
1103 W Liberty St
Ste 4050
Farmington, MO 63640
Phone (573) 760-8253
2630 Highway K
O Fallon, MO 63368
Phone (636) 240-5454
Interoperability endpoints
- https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2021018076 | MO | |
| Nurse Practitioner | 363L00000X | 2021018076 | MO | Yes |
Addresses
Primary practice location
1103 W Liberty St Ste 4050C
Farmington, MO 63640-1921
Mailing address
1103 W Liberty St Ste 4050C
Farmington, MO 63640-1921
Phone (573) 760-8253
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
Other providers in Farmington, MO
- Avalon Obstetrics and Gynecology, P.C.
- Troy Constant Avendanio
- Axes Physical Therapy, LLC
- Sujatha R Ayyagari
- Joan Azoury
- Christine Bacon
- Bailey Street Residential Care 1
- Aaron Baker
- Cheryl June Ballew
- Dana Barlow
All providers in Farmington, MO · Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.