Individual provider Active NPI

Marisa Michelle Laughrey, MD

  • Pediatrics Physician
  • St Johns, FL
National Provider Identifier
1700400496
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME163085 Issued in FL
Practice address
4125 Race Track Rd Unit 104
St Johns, FL 32259-2389
Phone
(904) 222-6364
Fax
(904) 342-0442
NPI assigned
May 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME163085 FL Primary

Addresses

Primary practice location

4125 Race Track Rd Unit 104
St Johns, FL 32259-2389

Mailing address

4125 Race Track Rd Unit 104
St Johns, FL 32259-2389
Phone (904) 222-6364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME163085FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrics of St. Augustine Pediatrics Past Accepting new patients
Healthy Steps Pediatrics Past Accepting new patients
Pediatrica Health of Florida, LLC PastSince Sep 8, 2024 Accepting new patients

Organizations & group practices 3

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": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1700400496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 RACE TRACK RD UNIT 104",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322592389",
            "telephone_number": "904-222-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 RACE TRACK RD UNIT 104",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322592389",
            "telephone_number": "904-222-6364",
            "fax_number": "904-342-0442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUGHREY",
        "first_name": "MARISA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME163085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.