Active NPI
Lauren Elizabeth Pearson
- Nurse Practitioner
- Johnson City, TN
National Provider Identifier
1508523424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 32177
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 264212 | Other | TN | TN NURSING LICENSE |
| 32177 | Other | TN | APRN LICENSE |
| 201402144RN | Other | OR | RN NURSING LICENSE |
| 202212408NP-PP | Other | OR | APRN 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
| License | State | Type | Specialty |
|---|---|---|---|
| 201402144RN | OR | MD | Nursing Care Agency |
| 202212408NP-PP | OR | MD | Nurse Practitioner |
| 32177 | TN | MD | Nurse 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.