Laurie De Roque

Primary specialty

ContractorTaxonomy code 171W00000X

License

OTR1268 Issued in AR

Practice address

851 Yellowjacket LN
Clinton, AR 72031-6873

Phone

(501) 745-6034

NPI assigned

Jan 3, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Superintendent of Clinton School

  • Local Education Agency (LEA)
  • Clinton, AR
  • NPI 1902973100
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1881751279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 COLUMBIA DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 YELLOWJACKET LN",
            "city": "CLINTON",
            "state": "AR",
            "postal_code": "720316873",
            "telephone_number": "501-745-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ROQUE",
        "first_name": "LAURIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "AR",
            "license": "OTR1268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darren Crymes, PHARMD
• Shelly Daud, L.P.E
• Cassady Davis, RECOVERY ASSISTANT
• Jodi Davis, PHARM D
• Ramey Dawson
• Jessica Dean
• Sheila Debow, RECOVERY ASSISTANT
• Martha Dennis
• Melanie Paige Diorio, CRNA, MS
• Dodd Family Practice, PLLC

• Contractor in Clinton, AR
• Providers in Clinton, AR by specialty
• Contractor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.