Individual provider Active NPI

Lauren Hanley, FNP

  • Family Nurse Practitioner
  • Northport, AL
National Provider Identifier
1629497508
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-177987 Issued in AL
Practice address
4280 Watermelon Rd Ste 110
Northport, AL 35473
Phone
(205) 710-3838
NPI assigned
Apr 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP125229 TX
Family Nurse Practitioner 363LF0000X 828524 TX
Family Nurse Practitioner 363LF0000X 1-177987 AL Primary

Addresses

Primary practice location

4280 Watermelon Rd Ste 110
Northport, AL 35473

Mailing address

4280 Watermelon Rd Ste 110
Northport, AL 35473-5163
Phone (678) 982-0069

Other practice location 1

1907 Cypress Creek Rd
Suite 104
Cedar Park, TX 78613-4150
Phone (512) 346-7966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 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
I20191108000491 AL Practitioner - Nurse Practitioner 6608166756 Reassigns benefits to 1 organization
I20210301000868 GA Practitioner - Nurse Practitioner 6608166756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Twelvestone Infusion Centers LLCGroup PAC ID 6800151424, 64 clinicians

Practice addresses (Care Compare)

125 Oakside CT
Suite 201
Canton, GA 30114-2498
Phone (844) 893-0012

2920 Ronald Reagan Blvd
Suite 103
Cumming, GA 30041-7578
Phone (844) 893-0012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
828524TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Twelvestone Infusion Centers LLC CurrentSince Mar 4, 2024 Accepting new patients
Rural Urgent Care LLC CurrentSince Jan 11, 2021 Accepting new patients
Rural Urgent Care LLC CurrentSince Jan 11, 2021 Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

1925 W Main St
#120
Centre, AL 35960
Phone (256) 677-4552

1408 Tallahassee Hwy
Ste Z
Bainbridge, GA 39819
Phone (229) 400-9033

125 Oakside Ct
Ste 201
Canton, GA 30114

2920 Ronald Reagan Blvd
Ste 103
Cumming, GA 30041

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1629497508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 WATERMELON RD STE 110",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735163",
            "telephone_number": "678-982-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 WATERMELON RD STE 110",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "35473",
            "telephone_number": "205-710-3838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1907 Cypress Creek Rd",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Cedar Park",
            "state": "TX",
            "postal_code": "786134150",
            "country_code": "US",
            "telephone_number": "512-346-7966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANLEY",
        "first_name": "LAUREN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP125229",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "828524",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-177987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.