Individual provider Active NPI

Patricia Lasley

  • Family Nurse Practitioner
  • Deerfield Beach, FL
National Provider Identifier
1831631910
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016020592 Issued in MO
Practice address
600 W Hillsboro Blvd Ste 10
Deerfield Beach, FL 33441-1609
Phone
(954) 990-2056
NPI assigned
Nov 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2016020592 MO Primary

Addresses

Primary practice location

600 W Hillsboro Blvd Ste 10
Deerfield Beach, FL 33441-1609

Mailing address

307 N Main St
Fair Play, MO 65649-9322
Phone (417) 599-3056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20170118000498 MO Practitioner - Nurse Practitioner 7618259110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ozarks Resource GroupGroup PAC ID 6002068723, 12 clinicians

Practice addresses (Care Compare)

111 N Main St
Urbana, MO 65767-9152
Phone (417) 993-1002

18614 Jackson St
Hermitage, MO 65668-8204
Phone (417) 745-0103

Hospital & facility affiliations

  • Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016020592MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Resource Group CurrentSince Aug 19, 2019 Accepting new patients
Ozarks Resource Group CurrentSince Aug 19, 2019 Accepting new patients

Locations

18614 Jackson St
Hermitage, MO 65668
Phone (417) 745-0103

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1831631910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 N MAIN ST",
            "city": "FAIR PLAY",
            "state": "MO",
            "postal_code": "656499322",
            "telephone_number": "417-599-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W HILLSBORO BLVD STE 10",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "334411609",
            "telephone_number": "954-990-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASLEY",
        "first_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-07",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016020592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.