Laura Paige Slack, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME105733 Issued in FL

Practice address

1620 Frederica Rd
St Simons Island, GA 31522-2600

Phone

(912) 268-2103

NPI assigned

Feb 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1497051767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 FREDERICA RD",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222600",
            "telephone_number": "305-778-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 FREDERICA RD",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222600",
            "telephone_number": "912-268-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "LAURA",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-04",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME105733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seaworthy Health LLC
• Yasmin Roisin Seay, MD
• Katie M Seymour, MPT
• William F Shivers Jr., M.D.
• John Franklin Sisley III, M.D.
• Amauri Smith, PT, DPT
• James Stratton Snow Jr., D.O.
• Southeast Georgia Therapy LLC
• Southeastern Health Services, Inc.
• Southern Crescent Surgical Assisting P C

• Family Medicine Physician in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.

Verify at the official NPI Registry.