Individual provider Active NPI

Lauren Elizabeth Pearson

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1508523424
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
32177 Issued in TN
Practice address
516 W Oakland Ave Ste 101
Johnson City, TN 37604-1677
Phone
(423) 888-0399
NPI assigned
Nov 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 201402144RN OR
Nurse Practitioner 363L00000X 202212408NP-PP OR
Nurse Practitioner 363L00000X 32177 TN Primary

Addresses

Primary practice location

516 W Oakland Ave Ste 101
Johnson City, TN 37604-1677

Mailing address

1404 Crescent Dr
Kingsport, TN 37664-2036
Phone (601) 540-0872

Other practice location 1

7820 NE Holman St Ste B9
Portland, OR 97218-2859
Phone (601) 540-0872

Other identifiers 4

IdentifierTypeStateIssuer
264212OtherTNTN NURSING LICENSE
32177OtherTNAPRN LICENSE
201402144RNOtherORRN NURSING LICENSE
202212408NP-PPOtherORAPRN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
201402144RNORMDNursing Care Agency
202212408NP-PPORMDNurse Practitioner
32177TNMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1637971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1508523424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 CRESCENT DR",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376642036",
            "telephone_number": "601-540-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 W OAKLAND AVE STE 101",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376041677",
            "telephone_number": "423-888-0399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7820 NE Holman St Ste B9",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972182859",
            "country_code": "US",
            "telephone_number": "601-540-0872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-27",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "OR",
            "license": "201402144RN",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "202212408NP-PP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "32177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN NURSING LICENSE",
            "identifier": "264212",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "32177",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN NURSING LICENSE",
            "identifier": "201402144RN",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE",
            "identifier": "202212408NP-PP",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.