Laura Shallenberger, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

TMA052595 Issued in PA

Practice address

564 W Broad St
Hazleton, PA 18201-6108

Phone

(570) 501-6400

Fax

(570) 453-2353

NPI assigned

Sep 27, 2011

Last updated

Apr 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Laura Temprine Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Hazleton Professional Services

  dba Lehigh Valley Physician Group-Hazleton

  • Internal Medicine Physician
  • Hazleton, PA
  • NPI 1952464638
  Medicare reassignment NPD
• Lehigh Valley Physician Group

  dba LVPG Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment
• Lehigh Valley Physician Group

  dba LVH Endocrinology - Tower Place

  • Endocrinology, Diabetes & Metabolism Physician
  • Allentown, PA
  • NPI 1013081876
  NPD
• Lehigh Valley Physician Group

  dba LVPG Family and Internal Medicine - East Stroudsburg

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1891078796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1830",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181051830",
            "telephone_number": "484-862-3313",
            "fax_number": "484-664-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 W BROAD ST",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182016108",
            "telephone_number": "570-501-6400",
            "fax_number": "570-453-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALLENBERGER",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-27",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "TMA052595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "TEMPRINE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Suzanne Marie Schaeffer, LPC, MC, NCC, CCMHC
• Kristie Scheib, LPC
• Robert Eugene Seaman, D.M.D.
• Frank Seratch III, MPT
• Sarah N Seratch, MPT
• Michael Dean Sheaffer, DO
• Stephen N Shoemaker, D.O.
• Shelly Shoup
• Chaya Shuchat, CPNP
• Jude Francis Sidari, MD

• Medical Physician Assistant in Hazleton, PA
• Providers in Hazleton, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.