Individual provider Active NPI

Laura Lee Scott, NP-C

  • Family Nurse Practitioner
  • Ammon, ID
National Provider Identifier
1679180244
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
66030 Issued in ID
Practice address
1547 Midway Ave Suite B
Ammon, ID 83406-6912
Phone
(208) 497-0429
Fax
(208) 497-0430
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 50162 ID
Family Nurse Practitioner 363LF0000X 66030 ID Primary

Addresses

Primary practice location

1547 Midway Ave Suite B
Ammon, ID 83406-6912

Mailing address

5294 Free Ave
Iona, ID 83427-4912
Phone (208) 680-4915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20201214002719 ID Practitioner - Nurse Practitioner 8123430204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Root Cause Integrative Medicine LLCGroup PAC ID 2062753098, 5 clinicians

Practice addresses (Care Compare)

1547 Midway Ave
Suite B
Ammon, ID 83406-6912
Phone (208) 497-0429

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50162IDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Sports & Spine CurrentSince Aug 6, 2024 Accepting new patients

Locations

1547 Midway Ave
#B
Ammon, ID 83406
Phone (208) 360-6770

Organizations & group practices 2

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": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1679180244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5294 FREE AVE",
            "city": "IONA",
            "state": "ID",
            "postal_code": "834274912",
            "telephone_number": "208-680-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1547 MIDWAY AVE SUITE B",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066912",
            "telephone_number": "208-497-0429",
            "fax_number": "208-497-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "LAURA",
        "middle_name": "LEE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ID",
            "license": "50162",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "66030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ammon, ID

Sources for this page

Verify at the official NPI Registry.