Individual provider Active NPI

Laura Gremillion Largent, CNM, WHNP

  • Women's Health Nurse Practitioner
  • Rogers, AR
National Provider Identifier
1811487945
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R091912 Issued in AR
Practice address
2203 S Promenade Blvd Ste 5185
Rogers, AR 72758-8722
Phone
(479) 480-7200
NPI assigned
May 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R091912 AR Primary

Addresses

Primary practice location

2203 S Promenade Blvd Ste 5185
Rogers, AR 72758-8722

Mailing address

333 S Desplaines St Ste 201
Chicago, IL 60661-5514

Other names 1

  • Laura Katherine Gremillion Former name

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)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R091912ARMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peach State Medical Practice, PC Past Accepting new patients
Peach State Medical Practice, PC Past Accepting new patients

Organizations & group practices 2

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": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1811487945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S DESPLAINES ST STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606615514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 S PROMENADE BLVD STE 5185",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727588722",
            "telephone_number": "479-480-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARGENT",
        "first_name": "LAURA",
        "middle_name": "GREMILLION",
        "name_prefix": "Ms.",
        "credential": "CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AR",
            "license": "R091912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "GREMILLION",
            "middle_name": "KATHERINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rogers, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.