Lauren Leachman Jackson, FNP
Individual provider Active NPI Family Nurse Practitioner · Carrollton, VA
NPI 1649867656 · NPPES record last updated Jan 30, 2025
Key facts
- NPI
- 1649867656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 0024180676 (VA)
- Practice address
- 20209 Sentara Way Ste 100
Carrollton, VA 23314-3573 - Phone
- (757) 772-6125
- NPI assigned
- Dec 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220110001452 | VA | Practitioner - Nurse Practitioner | 6002208758 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Velocity Urgent Care, LLC | Current |
Accepting new patients |
Locations
20209 Sentara Way
Ste 100
Carrollton, VA 23314
Phone (757) 542-1100
4374 New Town Ave
Williamsburg, VA 23188
Phone (757) 772-6124
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 0024180676 | VA | Yes |
Addresses
Primary practice location
20209 Sentara Way Ste 100
Carrollton, VA 23314-3573
Mailing address
224 Peck LN
Suffolk, VA 23434-8691
Phone (757) 724-2520
Other providers in Carrollton, VA
- Home-Based Care Partners of VA Inc
- Jennifer J Huband
- Humanity Home Health LLC
- Crystal Hunt
- Jeffrey Irwin
- Tina Jackson
- Jennifer Anne Johnston
- Nicole D Jones
- Tara Jones
- James Albert Jowdy
All providers in Carrollton, VA · Family Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.