Laura Nicole Kelleway, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903033 Issued in MS

Practice address

23 County Road 205
Oxford, MS 38655-9794

Phone

(901) 268-9862

NPI assigned

Nov 9, 2019

Last updated

Nov 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Laura Nicole Heaberlin Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: laura.kelleway.1@28179.direct.athenahealth.com

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.

• North Mississippi Primary Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ashland, MS
  • NPI 1821092552
  Medicare reassignment NPD
• North Mississippi Primary Health Care, Inc.

  dba North Mississippi Primary Health Care, Inc. Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Ashland, MS
  • NPI 1376009407
  NPD
• North Mississippi Primary Health Care, Inc.

  dba Charger Health and Wellness

  • Federally Qualified Health Center (FQHC)
  • Oxford, MS
  • NPI 1760077481
  NPD
• North Mississippi Primary Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Ripley, MS
  • NPI 1992190367
  NPD
• North Mississippi Primary Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Booneville, MS
  • NPI 1083009450
  NPD (past)

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

{
    "created_epoch": "1573257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573257600000",
    "number": "1710522198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 COUNTY ROAD 205",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386559794",
            "telephone_number": "901-268-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 COUNTY ROAD 205",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386559794",
            "telephone_number": "901-268-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEWAY",
        "first_name": "LAURA",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-09",
        "last_updated": "2019-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "HEABERLIN",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lorral Alexis Kanauss
• Arjun Kandel
• Kbccms, LLC
• Amanda Keel, M. ED
• Maggie Ruth Keller
• Chrystal Kelley, CRNA
• Staci Michelle Kellum, M.S., CCC-SLP
• Mark Allen Kelly, P-LPC
• Timothy Richard Kelly, MD
• Kristen Tai Kern, MA

• Family Nurse Practitioner in Oxford, MS
• Providers in Oxford, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.