Individual provider Active NPI

Agne Laramore, CNP

  • Family Nurse Practitioner
  • Copley, OH
National Provider Identifier
1568078491
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP0026804 Issued in OH
Practice address
4531 Northledge CT
Copley, OH 44321-3413
Phone
(330) 990-0306
NPI assigned
Sep 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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 APRN.CNP0026804 OH Primary

Addresses

Primary practice location

4531 Northledge CT
Copley, OH 44321-3413

Mailing address

4531 Northledge CT
Copley, OH 44321-3413
Phone (330) 990-0306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20201124002586 OH Practitioner - Nurse Practitioner 0446661391 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santibanez Pac Ohio IncGroup PAC ID 7416391545, 36 clinicians

Practice addresses (Care Compare)

4389 Medina Rd
Copley, OH 44321-1388
Phone (234) 815-5100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP0026804OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Santibanez Pac Ohio Inc CurrentSince Jan 1, 2024 Accepting new patients
Premium Quality NP, LLC CurrentSince Nov 4, 2020 Accepting new patients
4M Hospitalist Services, LLC CurrentSince May 1, 2021 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

29 N Adams St
Akron, OH 44304
Phone (330) 572-7293

4389 Medina Rd
Copley, OH 44321
Phone (234) 678-9332

3557 Embassy Pkwy
Fairlawn, OH 44333
Phone (330) 670-1005

1290 Fairchild Ave
Kent, OH 44240
Phone (330) 678-4912

555 Springbrook Dr
Medina, OH 44256
Phone (330) 725-3393

5155 Buehlers Dr
Ste 108
Medina, OH 44256

565 Bryn Mawr St
Ravenna, OH 44266
Phone (330) 297-5781

275 E Sunset Dr
Rittman, OH 44270
Phone (330) 927-2060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1568078491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 NORTHLEDGE CT",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443213413",
            "telephone_number": "330-990-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 NORTHLEDGE CT",
            "city": "COPLEY",
            "state": "OH",
            "postal_code": "443213413",
            "telephone_number": "330-990-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARAMORE",
        "first_name": "AGNE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP0026804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Copley, OH

Sources for this page

Verify at the official NPI Registry.