Individual provider Active NPI

Laura Sue Wheeler, RN,MSN,FNP,MHNP

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1508800913
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP0000012072 Issued in TN
Practice address
4307 Ball Camp Pike
Knoxville, TN 37921-3313
Phone
(865) 524-1234
Fax
(865) 524-2169
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP0000012072 TN Primary

Addresses

Primary practice location

4307 Ball Camp Pike
Knoxville, TN 37921-3313

Mailing address

4307 Ball Camp PK.
Knoxville, TN 37921
Phone (865) 524-1234

Other identifiers 1

IdentifierTypeStateIssuer
4196048MedicaidTN

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)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
12072TNMDPhysical Therapist
AP0000012072TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Medical Group, P.C. Past Accepting new patients
Advanced Medical Group Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1508800913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4307 BALL CAMP PK.",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37921",
            "telephone_number": "865-524-1234",
            "fax_number": "865-524-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4307 BALL CAMP PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379213313",
            "telephone_number": "865-524-1234",
            "fax_number": "865-524-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "LAURA",
        "middle_name": "SUE",
        "credential": "RN,MSN,FNP,MHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "AP0000012072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4196048",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.