Individual provider Active NPI

Laura C Horn, PAC

  • Surgical Physician Assistant
  • Saint Peters, MO
National Provider Identifier
1528041696
Registry record updated Jun 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
112 Piper Hill Dr
Suite 9
Saint Peters, MO 63376-1690
Phone
(636) 441-3444
Fax
(636) 926-2858
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary
Emergency Medicine Physician 207P00000X 2002028066 MO

Addresses

Primary practice location

112 Piper Hill Dr
Suite 9
Saint Peters, MO 63376-1690

Mailing address

112 Piper Hill Dr
Suite 9
Saint Peters, MO 63376-1690
Phone (636) 441-3444

Other identifiers 1

IdentifierTypeStateIssuer
P00657543OtherMORR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090224000730 MO Practitioner - Physician Assistant 9638068489 Reassigns benefits to 2 organizations
I20150317002375 IL Practitioner - Physician Assistant 9638068489 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Saint Louis University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy East Ambulatory Services LLCGroup PAC ID 2365739240, 102 clinicians

Practice addresses (Care Compare)

1111 W Pearce Blvd
Wentzville, MO 63385-1020
Phone (636) 856-5363

2031 Zumbehl Rd
Saint Charles, MO 63303-2723
Phone (636) 206-2690

2991 Hwy K
O Fallon, MO 63368-7862
Phone (636) 435-2333

409 Lafayette Ctr
Manchester, MO 63011-3943
Phone (636) 707-0764

6167 Mid Rivers Mall Dr
Saint Peters, MO 63304-1105
Phone (636) 364-4990

6460 Ronald Reagan Dr
Lake St Louis, MO 63367-2645
Phone (636) 205-9613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2002028066MOMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laser Spine Institute, LLC Past Accepting new patients
BC Missouri Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Lincoln County Hospital Past Accepting new patients
North County Emergency Physicians, LLP Emergency Medicine Past Accepting new patients

Organizations & group practices 7

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244505600000",
    "number": "1528041696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 PIPER HILL DR",
            "address_2": "SUITE 9",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761690",
            "telephone_number": "636-441-3444",
            "fax_number": "636-926-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 PIPER HILL DR",
            "address_2": "SUITE 9",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761690",
            "telephone_number": "636-441-3444",
            "fax_number": "636-926-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "LAURA",
        "middle_name": "C",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2009-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2002028066",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00657543",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.