Carey Ann Ellis Laffoon, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A01649 Issued in AR

Practice address

101 Skyline Dr
Russellville, AR 72801-3363

Phone

(479) 968-2345

Fax

(479) 890-2497

NPI assigned

Jun 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Carey A Bosold Former name

Medicare fee-for-service enrollment

Enrolled in AR

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

State licenses

Practice roles

Locations

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.

• St Mary's Physician Services LLC

  • General Practice Physician
  • Russellville, AR
  • NPI 1124084991
  Medicare reassignment NPD
• St Marys Physician Services, LLC

  • Durable Medical Equipment & Medical Supplies
  • Russellville, AR
  • NPI 1063626117
  NPD
• St Marys Physician Services, LLC

  dba Cardiology Associates of North Central Arkansas

  • Interventional Cardiology Physician
  • Russellville, AR
  • NPI 1720356207
  NPD (past)

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1720284318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SKYLINE DR",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013363",
            "telephone_number": "479-890-2474",
            "fax_number": "479-890-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SKYLINE DR",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013363",
            "telephone_number": "479-968-2345",
            "fax_number": "479-890-2497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Burton Hills Blvd Ste 175",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372156403",
            "country_code": "US",
            "telephone_number": "615-988-2014",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1601 N Church St",
            "address_purpose": "LOCATION",
            "city": "Atkins",
            "state": "AR",
            "postal_code": "728233234",
            "country_code": "US",
            "telephone_number": "479-641-2255",
            "fax_number": "479-641-1889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 W C Pl",
            "address_purpose": "LOCATION",
            "city": "Russellville",
            "state": "AR",
            "postal_code": "728012705",
            "country_code": "US",
            "telephone_number": "479-967-7717",
            "fax_number": "866-280-8464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS LAFFOON",
        "first_name": "CAREY",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A01649",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A01649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAREY",
            "last_name": "BOSOLD",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Morgan Earp
• Laura Easter, MHPP
• Erica Fern Edwards
• Olivia Rae Edwards
• Eldercare of Arkansas VI, Inc. (StoneBridge Russellville)
• Brianna Elms, QBHP
• Emerging Hope Therapy, LLC
• Emeritus Corporation (Wildflower Retirement)
• Emeritus Properties Ark Wildflower LLC (Brookdale Russellville)
• Lauren Elizabeth Emerson

• Family Nurse Practitioner in Russellville, AR
• Providers in Russellville, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.