Individual provider Active NPI

Lauren Nicole Barnack, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1831602556
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09091 Issued in NC
Practice address
1237 Harding PL
Ste 4300
Charlotte, NC 28204
Phone
(704) 373-0212
NPI assigned
Nov 16, 2017
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-09091 NC Primary

Addresses

Primary practice location

1237 Harding PL
Ste 4300
Charlotte, NC 28204

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

200 Medical Park Dr
Ste 230
Concord, NC 28025-2982
Phone (704) 403-1349

Other practice location 2

10650 Park Rd
Charlotte, NC 28210-8538
Phone (704) 667-3840

Other practice location 3

1237 Harding Pl
Ste 3100
Charlotte, NC 28204
Phone (704) 373-0212

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lbarnack631689@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230810002970 FL Practitioner - Physician Assistant 9335407949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4202 E Fowler Ave
Tampa, FL 33620-6750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
University Medical Service Association Inc CurrentSince Jul 24, 2023 Accepting new patients
University Medical Service Association Inc CurrentSince Jul 24, 2023 Accepting new patients
University Medical Service Association Inc Physician Assistant Past Accepting new patients

Locations

12901 Bruce B Downs Blvd
#62
Tampa, FL 33612

2 Tampa General Cir
Tampa, FL 33606
Phone (813) 259-0929

4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: lbarnack276358@direct.tgh.org
  • Direct secure messaging: lbarnack631689@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1831602556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 HARDING PL",
            "address_2": "STE 4300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-373-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Medical Park Dr",
            "address_2": "Ste 230",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252982",
            "country_code": "US",
            "telephone_number": "704-403-1349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-3840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-373-0212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARNACK",
        "first_name": "LAUREN",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2024-07-25",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lbarnack631689@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 4300",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.