Active NPI
Breanna Marie Lazar, NP
- Family Nurse Practitioner
- Redding, CA
National Provider Identifier
1417569575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95015119
- Practice address
- 1035 Placer St
Redding, CA 96001-1170 - Phone
- (530) 246-5710
- NPI assigned
- Aug 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 95015119 | CA | |
| Family Nurse Practitioner | 363LF0000X | 95015119 | CA | Primary |
Addresses
Primary practice location
1035 Placer St
Redding, CA 96001-1170
Mailing address
3001 Luke TRL
Redding, CA 96002-9679
Phone (661) 878-1800
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95015119 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shasta Community Health Center | Current | Accepting new patients | |
| Shasta Community Health Center | Current | Accepting new patients | |
| Shasta Community Health Center | Current | Accepting new patients | |
| Mendocino Coast Clinics Inc | Past | Accepting new patients |
Locations
1035 Placer St
Redding, CA 96001
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- breanna.lazar.p1@direct.mccinc.nextgenshare.com
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Redding, CA
- NPI 1114533171
-
- Federally Qualified Health Center (FQHC)
- Redding, CA
- NPI 1356815542
-
- Federally Qualified Health Center (FQHC)
- Redding, CA
- NPI 1952328403
-
- Federally Qualified Health Center (FQHC)
- Fort Bragg, CA
- NPI 1083783757
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1417569575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 LUKE TRL",
"city": "REDDING",
"state": "CA",
"postal_code": "960029679",
"telephone_number": "661-878-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1035 PLACER ST",
"city": "REDDING",
"state": "CA",
"postal_code": "960011170",
"telephone_number": "530-246-5710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZAR",
"first_name": "BREANNA",
"middle_name": "MARIE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-20",
"last_updated": "2020-09-28",
"certification_date": "2020-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CA",
"license": "95015119",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95015119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.