Laci Jo Vanderboegh, MSN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5019962 Issued in NC

Practice address

1700 Tarboro St W Ste 100
Wilson, NC 27893-3481

Phone

(252) 399-5314

NPI assigned

Apr 26, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, FL2 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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ibrahim Heart Clinic PLLCGroup PAC ID 4688958648, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peoples Home Health LLC Home health agency, Pensacola, FL, CCN 109664
• Amedisys Home Health Home health agency, Pensacola, FL, CCN 108309
• Baptist Hospital Hospital, Pensacola, FL, CCN 100093

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: laci.vanderboegh.1@30358.direct.athenahealth.com
• Direct secure messaging: laci.vanderboegh.1@9600.direct.athenahealth.com

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.

• Ibrahim Heart Clinic PLLC

  • Clinical Cardiac Electrophysiology Physician
  • Jacksonville, FL
  • NPI 1629511035
  Medicare reassignment Care Compare group NPD
• DLP Wilson Physician Practices LLC

  • Family Medicine Physician
  • Wilson, NC
  • NPI 1932521010
  Medicare reassignment NPD
• DLP Wilson Physician Practices LLC

  dba Wilson Primary Care

  • Rural Health Clinic/Center
  • Wilson, NC
  • NPI 1992482079
  NPD
• Primary Care House Calls PA

  • Medical Physician Assistant
  • Gulf Breeze, FL
  • NPI 1770902462

  Family

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Florida, LLC

  dba Amedisys Home Health

  • Home Health Agency
  • Pensacola, FL
  • NPI 1679685085
  Care Compare affiliation
• Baptist Health Care, Inc

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1700979465
  Care Compare affiliation
• Peoples Home Health LLC

  • Home Health Agency
  • Pensacola, FL
  • NPI 1801931837
  Care Compare affiliation

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1629824032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 GREENBRIAR RD NW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278962146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TARBORO ST W STE 100",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933481",
            "telephone_number": "252-399-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBOEGH",
        "first_name": "LACI",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urgent Cares of America North Carolina Inc (FastMed Urgent Care of Wilson)
• Ijeoma Agnes Uwakwe, PHARM.D
• Prince U Uzuka, LCAS-A
• Amy Van Vooren, P.A.
• Valerie Vanderbeek, M.S., CCC-A
• Varun Vankeshwaram, M.D.
• Lana Smith Vanstory, MPAS, PA-C
• Dana Marie Varnell, PA-C
• Shannon Vasilinda, RDN, LDN
• Kathleen Vaughan, MS, CCC-SLP

• Family Nurse Practitioner in Wilson, NC
• Providers in Wilson, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.