Individual provider Active NPI

Lauren Haley Holbrook, NP

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1417515479
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F01191429 Issued in MS
Practice address
7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone
(901) 683-0055
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X F01191429 MS Primary

Addresses

Primary practice location

7945 Wolf River Blvd
Germantown, TN 38138-1762

Mailing address

7714 Poplar Ave Ste 200
Germantown, TN 38138-3941
Phone (901) 683-0055

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGMedicaidMS
PENDINGMedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210127000424 MS Practitioner - Nurse Practitioner 6608280045 Reassigns benefits to 1 organization
I20210128002533 TN Practitioner - Nurse Practitioner 6608280045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The West Clinic P.C.Group PAC ID 2668360579, 115 clinicians

Practice addresses (Care Compare)

7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone (901) 683-0055

Merit-based Incentive Payment System (MIPS)

Final score
90.15 of 100Reported as subgroup
Quality
83.22
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F01191429MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The West Clinic P.C. CurrentSince Jan 1, 2021 Accepting new patients
The West Clinic P.C. Single Specialty CurrentSince Jan 1, 2021 Accepting new patients
The West Clinic P.C. Past Accepting new patients

Locations

2001 State Dr
Corinth, MS 38834
Phone (662) 286-3694

7668 Airways Blvd
Southaven, MS 38671
Phone (662) 349-9556

240 Grandview Dr
Brighton, TN 38011
Phone (901) 475-0678

7945 Wolf River Blvd
Memphis, TN 38138
Phone (901) 448-7000

7714 Poplar Ave
Ste 200
Memphis, TN 38138
Phone (901) 322-9080

1588 Union Ave
Memphis, TN 38104
Phone (901) 276-2410

1290 Kelley Dr
Paris, TN 38242
Phone (270) 554-0011

Interoperability endpoints

  • Direct secure messaging: lholbrook29462@mlh.direct-ci.com

Organizations & group practices 3

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1417515479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7714 POPLAR AVE STE 200",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383941",
            "telephone_number": "901-683-0055",
            "fax_number": "901-685-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381762",
            "telephone_number": "901-683-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "LAUREN",
        "middle_name": "HALEY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "F01191429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.