Individual provider Active NPI

Laura Harvey Nazzaro, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1689920357
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
817885 Issued in TX
Practice address
10420 Park Rd Ste 300
Charlotte, NC 28210-8502
Phone
(980) 237-4766
Fax
(980) 404-2274
NPI assigned
Jul 31, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 817885 TX Primary

Addresses

Primary practice location

10420 Park Rd Ste 300
Charlotte, NC 28210-8502

Mailing address

10420 Park Rd Ste 300
Charlotte, NC 28210-8502
Phone (980) 237-4766

Other practice location 1

941 York Dr
ste 205
DeSoto, TX 75115-2065
Phone (972) 283-6286

Other practice location 2

10440 Park Rd Ste 300
Charlotte, NC 28210-8544
Phone (980) 237-4766

Other names 1

  • Laura Harvey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 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
I20170223002415 SC Practitioner - Nurse Practitioner 2668603416
I20201028001783 NC Practitioner - Nurse Practitioner 2668603416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Univ of Illinois at Chicago College of Dentistry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

10420 Park Rd
Suite 300
Charlotte, NC 28210-8502
Phone (980) 237-4766

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
817885TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric and Family Behavioral Health Acquisition Group PLLC Psychiatric/Mental Health CurrentSince Oct 19, 2020 Accepting new patients

Locations

10440 Park Rd
Ste 300
Charlotte, NC 28210
Phone (980) 237-4766

10420 Park Rd
Ste 300
Charlotte, NC 28210
Phone (980) 237-4766

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1689920357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10420 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108502",
            "telephone_number": "980-237-4766",
            "fax_number": "980-404-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108502",
            "telephone_number": "980-237-4766",
            "fax_number": "980-404-2274"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "941 York Dr",
            "address_2": "ste 205",
            "address_purpose": "LOCATION",
            "city": "DeSoto",
            "state": "TX",
            "postal_code": "751152065",
            "country_code": "US",
            "telephone_number": "972-283-6286",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10440 Park Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108544",
            "country_code": "US",
            "telephone_number": "980-237-4766",
            "fax_number": "980-404-2274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAZZARO",
        "first_name": "LAURA",
        "middle_name": "HARVEY",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "817885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "HARVEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.