Organization Active NPI

NKL Neurology PLC

  • Specialist
  • Scottsdale, AZ
National Provider Identifier
1871811802
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35284 Issued in AZ
Legal business name
NKL NEUROLOGY PLC
Practice address
9817 N 95TH St Ste 110
Scottsdale, AZ 85258-4587
Phone
(480) 779-3997
Fax
(480) 779-1305
NPI assigned
May 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Authorized official

Name
Nida K Laurin, M.D.NPI 1306887963
Title
Owner/Physician
Phone
(480) 779-3997

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 35284 AZ Primary

Addresses

Primary practice location

9817 N 95TH St Ste 110
Scottsdale, AZ 85258-4587

Mailing address

9817 N 95TH St Ste 110
Scottsdale, AZ 85258-4587
Phone (480) 779-3997

Other identifiers 1

IdentifierTypeStateIssuer
955263MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100728000596 AZ Part B Supplier - Clinic/Group Practice 2365575305 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

9817 N 95th St
Ste 110
Scottsdale, AZ 85258
Phone (480) 650-2944

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1871811802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9817 N 95TH ST STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584587",
            "telephone_number": "480-779-3997",
            "fax_number": "480-779-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9817 N 95TH ST STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584587",
            "telephone_number": "480-779-3997",
            "fax_number": "480-779-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NKL NEUROLOGY PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-14",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "LAURIN",
        "authorized_official_first_name": "NIDA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "480-779-3997",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "35284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "955263",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.