Lazuli Therapeutics, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

LAZULI THERAPEUTICS, LLC

Doing business as

Lazuli Therapeutics

Practice address

5800 McLeod Rd NE Ste D
Albuquerque, NM 87109-2467

Phone

(505) 508-1167

Fax

(505) 212-0332

NPI assigned

Jan 18, 2019

Organization subpart

No

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

Authorized official

Name

Marie Elizabeth Mugavin, PHDNPI 1417186560

Title

Owner

Phone

(505) 508-1167

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LAZULI THERAPEUTICS Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marie Elizabeth Mugavin, PHD, FNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
  • NPI 1417186560

  Family

  Medicare reassignment NPD Authorized official
• Kelly McPfimeloronti, PH.D.

  • Clinical Psychologist
  • Livingston, TX
  • NPI 1679711717
  NPD (past)

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1538633987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14888",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871914888",
            "telephone_number": "505-508-1167",
            "fax_number": "505-212-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 MCLEOD RD NE STE D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871092467",
            "telephone_number": "505-508-1167",
            "fax_number": "505-212-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAZULI THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2024-05-24",
        "certification_date": "2021-02-23",
        "status": "A",
        "authorized_official_last_name": "MUGAVIN",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-508-1167",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1417186560",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAZULI THERAPEUTICS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LAZULI THERAPEUTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Devon Nichole Layne, LMSW
• Allisha R Layton, CSW
• Emily Sarah Layton
• Kim Maria Layton
• Stephanie Lazo
• LBH Pharmacy LLC (Central Pharmacy)
• LDS Family Services (LDS Family Services NM Albuquerque)
• Le Angels
• Adrienne Le Blanc
• Michelle A Le Febre

• Family Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.