Individual provider Active NPI

Lara N. King, FNP

  • Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1679857932
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R856339 Issued in MS
Practice address
4803 29TH Ave Ste a
Meridian, MS 39305-2675
Phone
(601) 286-5477
Fax
(601) 286-5825
NPI assigned
Oct 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R856339 MS
Nurse Practitioner 363L00000X R856339 MS Primary

Addresses

Primary practice location

4803 29TH Ave Ste a
Meridian, MS 39305-2675

Mailing address

4803 29TH Ave Ste a
Meridian, MS 39305-2675
Phone (601) 286-5477

Other identifiers 1

IdentifierTypeStateIssuer
01384559MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20111103000189 MS Practitioner - Nurse Practitioner 0648443804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gregory a Auzenne MD PAGroup PAC ID 1658654850, 4 clinicians

Practice addresses (Care Compare)

4803 29TH Ave
Suite a
Meridian, MS 39305-2675
Phone (601) 286-5477

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory a. Auzenne MD, PA CurrentSince Apr 15, 2024 Accepting new patients

Locations

2100 13th St
Meridian, MS 39301
Phone (601) 485-4443

1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011

4803 29th Ave
Ste A
Meridian, MS 39305
Phone (601) 286-5477

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1679857932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4803 29TH AVE STE A",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393052675",
            "telephone_number": "601-286-5477",
            "fax_number": "601-286-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4803 29TH AVE STE A",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393052675",
            "telephone_number": "601-286-5477",
            "fax_number": "601-286-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "LARA",
        "middle_name": "N.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R856339",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R856339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01384559",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.