Individual provider Active NPI

Lauren Taylor Souza, PA-C, DMS, MSW

  • Physician Assistant
  • Hixson, TN
National Provider Identifier
1609206473
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2651 Issued in ME
Practice address
1025 Executive Dr Ste 100
Hixson, TN 37343-7917
Phone
(423) 870-3700
NPI assigned
Nov 15, 2013
Last updated
Dec 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2651 ME Primary
Mental Health Counselor 101YM0800X NU

Addresses

Primary practice location

1025 Executive Dr Ste 100
Hixson, TN 37343-7917

Mailing address

1025 Executive Dr Ste 100
Hixson, TN 37343-7917
Phone (423) 870-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, TN2 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
I20240508003582 ME Practitioner - Physician Assistant 7719328764
I20260320000340 TN Practitioner - Physician Assistant 7719328764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

1025 Executive Dr
Suite 100
Hixson, TN 37343-7917
Phone (423) 870-2030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2651MEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince May 18, 2024 Accepting new patients
Mainehealth Physician Assistant CurrentSince May 18, 2024 Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Interoperability endpoints

  • Direct secure messaging: lsouza709011@direct.mmc.mainehealth.org

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": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1609206473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 EXECUTIVE DR STE 100",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437917",
            "telephone_number": "423-870-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 EXECUTIVE DR STE 100",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437917",
            "telephone_number": "423-870-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "LAUREN",
        "middle_name": "TAYLOR",
        "credential": "PA-C, DMS, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA2651",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

Verify at the official NPI Registry.