Individual provider Active NPI

Laura M Pena, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • West Columbia, TX
National Provider Identifier
1528705308
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1076969 Issued in TX
Practice address
411 W Brazos Ave
West Columbia, TX 77486-2611
Phone
(979) 345-2525
NPI assigned
May 13, 2022
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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 1076969 TX Primary

Addresses

Primary practice location

411 W Brazos Ave
West Columbia, TX 77486-2611

Mailing address

411 W Brazos Ave
West Columbia, TX 77486-2611
Phone (979) 345-2525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20221004002452 TX Practitioner - Nurse Practitioner 0840676565 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1076969TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sweeny Hospital District CurrentSince Jun 20, 2022 Accepting new patients
Sweeny Hospital District CurrentSince Oct 13, 2024 Accepting new patients
Sweeny Hospital District CurrentSince Jun 20, 2022 Accepting new patients

Locations

303 N McKinney St
Ste B
Sweeny, TX 77480
Phone (979) 548-1875

303 N McKinney St
Ste E
Sweeny, TX 77480
Phone (979) 548-1515

303 N McKinney St
Ste G
Sweeny, TX 77480
Phone (979) 548-0090

303 N McKinney St
Ste H
Sweeny, TX 77480
Phone (713) 436-8166

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

411 W Brazos Ave
West Columbia, TX 77486
Phone (979) 345-2525

668 W Brazos Ave
West Columbia, TX 77486
Phone (979) 267-2137

Interoperability endpoints

  • Direct secure messaging: laura.pena.1@17497.direct.athenahealth.com

Organizations & group practices 3

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": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1528705308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W BRAZOS AVE",
            "city": "WEST COLUMBIA",
            "state": "TX",
            "postal_code": "774862611",
            "telephone_number": "979-345-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W BRAZOS AVE",
            "city": "WEST COLUMBIA",
            "state": "TX",
            "postal_code": "774862611",
            "telephone_number": "979-345-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "LAURA",
        "middle_name": "M",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1076969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, TX

Sources for this page

Verify at the official NPI Registry.