Individual provider Active NPI

Laureen Mushati-Makoko, NP-C

  • Nurse Practitioner
  • Hoover, AL
National Provider Identifier
1518377282
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-109952 Issued in AL
Practice address
5933 Lake Cyrus Dr
Hoover, AL 35244-4163
Phone
(256) 457-6397
NPI assigned
May 5, 2014
Last updated
May 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-109952 AL Primary

Addresses

Primary practice location

5933 Lake Cyrus Dr
Hoover, AL 35244-4163

Mailing address

5933 Lake Cyrus Dr
Hoover, AL 35244-4163
Phone (256) 457-6397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20140708001268 AL Practitioner - Nurse Practitioner 7315162336 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-109952ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern NP Associates, LLC CurrentSince Aug 7, 2016 Accepting new patients

Locations

22969 Highway 25
Columbiana, AL 35051
Phone (205) 669-1712

931 Fairfax Park
Tuscaloosa, AL 35406
Phone (205) 343-7301

Organizations & group practices 1

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": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1518377282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5933 LAKE CYRUS DR",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444163",
            "telephone_number": "256-457-6397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5933 LAKE CYRUS DR",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444163",
            "telephone_number": "256-457-6397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSHATI-MAKOKO",
        "first_name": "LAUREEN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-109952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

Verify at the official NPI Registry.