Individual provider Active NPI

Larie Roe, FNP-C

  • Family Nurse Practitioner
  • Plano, TX
National Provider Identifier
1750052858
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1055328 Issued in TX
Practice address
5136 Village Creek Dr
Plano, TX 75093-4496
Phone
(815) 471-1234
NPI assigned
Sep 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 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 76631 NM
Family Nurse Practitioner 363LF0000X 1055328 TX Primary

Addresses

Primary practice location

5136 Village Creek Dr
Plano, TX 75093-4496

Mailing address

5804 Corinth Chapel Rd
Parker, TX 75002-6447
Phone (815) 471-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220113000727 TX Practitioner - Nurse Practitioner 6901298421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vital Options PLLCGroup PAC ID 5597002527, 2 clinicians

Practice addresses (Care Compare)

318 W FM
544 Suite C4
Murphy, TX 75094-4652
Phone (972) 737-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76631NMMDFamily Nurse Practitioner
1055328TXMDFamily Nurse Practitioner

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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1750052858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5804 CORINTH CHAPEL RD",
            "city": "PARKER",
            "state": "TX",
            "postal_code": "750026447",
            "telephone_number": "815-471-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5136 VILLAGE CREEK DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934496",
            "telephone_number": "815-471-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROE",
        "first_name": "LARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "76631",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1055328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.