Individual provider Active NPI

Laura Belle Maupin, ARNP

  • Family Nurse Practitioner
  • Pace, FL
National Provider Identifier
1508383407
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3235012 Issued in FL
Practice address
4453 Highway 90
Pace, FL 32571-2066
Phone
(850) 905-0110
NPI assigned
Aug 23, 2017
Last updated
Sep 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 80673 WV
Family Nurse Practitioner 363LF0000X 3235012 FL Primary

Addresses

Primary practice location

4453 Highway 90
Pace, FL 32571-2066

Mailing address

4453 Highway 90
Pace, FL 32571-2066
Phone (850) 905-0110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200904001451 FL Practitioner - Nurse Practitioner 1850621392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4453 Hwy 90
Pace, FL 32571-2066
Phone 85090501102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3235012FLMDFamily Nurse Practitioner
80673WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quick Start Weight Loss & Wellness Center, Inc. Multi-Specialty Current Accepting new patients
Partners Family Medicine Practice & Recovery Center Inc Multi-Specialty CurrentSince Jun 1, 2020 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Multi-Specialty Past Accepting new patients

Locations

4453 Highway 90
Pace, FL 32571
Phone (850) 905-0110

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1508383407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4453 HIGHWAY 90",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325712066",
            "telephone_number": "850-905-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4453 HIGHWAY 90",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325712066",
            "telephone_number": "850-905-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUPIN",
        "first_name": "LAURA",
        "middle_name": "BELLE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "80673",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "3235012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pace, FL

Sources for this page

Verify at the official NPI Registry.