Laury Farrell, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71010496A Issued in IN

Practice address

3030 Lake Ave Ste 24
Fort Wayne, IN 46805-5428

Phone

(260) 705-4587

NPI assigned

Oct 22, 2020

Last updated

Oct 30, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chicagoland Infectious Disease PCGroup PAC ID 5193948362, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Chicagoland Infectious Disease PC

  • Infectious Disease Physician
  • South Holland, IL
  • NPI 1780002352

  IN

  Medicare reassignment Care Compare group NPD
• Cleanslate Medical Group of Indiana LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Alexandria, IN
  • NPI 1023464294
  Medicare reassignment NPD
• Legacy Treatment Center LLC

  • Addiction Medicine (Family Medicine) Physician
  • Fort Wayne, IN
  • NPI 1336940717
  Medicare reassignment NPD
• Hoosier Sports & Chiropractic LLC

  • Chiropractor
  • Fort Wayne, IN
  • NPI 1801114533
  NPD (past)
• Matthew 25, Inc

  • Primary Care Clinic/Center
  • Fort Wayne, IN
  • NPI 1992268635
  NPD (past)

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1891394599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7160 S STATE ROAD 9",
            "city": "COLUMBIA CITY",
            "state": "IN",
            "postal_code": "467259659",
            "telephone_number": "260-609-4256",
            "fax_number": "260-233-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 LAKE AVE STE 24",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055428",
            "telephone_number": "260-705-4587"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3110 E Coliseum Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468051554",
            "country_code": "US",
            "telephone_number": "260-213-4335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "LAURY",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IN",
            "license": "71010496A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71010496A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Farny, SLP
• Samantha Faron, MSW
• Ibad Ui-Haq Farooqui, MD
• Kimberly D Farouki, LCSW
• Terri Yvonne Farr, RN
• Shannon Farrell, AU.D., CCC-A
• Farrington Specialty Counseling Inc.
• Brooke Farrington, MSW, LCSW, CEDS-S
• Maiyah C Farrow
• Samir Cyrus Faruque, MD

• Nurse Practitioner in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.