Avita Medical Care

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

AVITA MEDICAL CARE

Practice address

6701 Democracy Blvd Ste 300
Bethesda, MD 20817-7500

Phone

(800) 484-2115

Fax

(800) 484-2115

NPI assigned

Oct 10, 2025

Organization subpart

No

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

Authorized official

Name

Laura Lee Minor, CRNP, FNP-BC, LMTNPI 1831812502

Title

Ceo

Phone

(202) 486-2881

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Practitioners 1

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

• Laura Lee Minor, CRNP, FNP-BC, LMT

  • Family Nurse Practitioner
  • Greenbelt, MD
  • NPI 1831812502

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1760054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1942175658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 DEMOCRACY BLVD STE 300",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177500",
            "telephone_number": "800-484-2115",
            "fax_number": "800-484-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 DEMOCRACY BLVD STE 300",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208177500",
            "telephone_number": "800-484-2115",
            "fax_number": "800-484-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVITA MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-10",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A",
        "authorized_official_last_name": "MINOR",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "202-486-2881",
        "authorized_official_credential": "CRNP, FNP-BC, LMT"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Elizabeth Auxier, M.S.
• Diana Avalos, NONE
• Avesta Mental Health (Avesta Ketamine and Wellness)
• Daniele Nanette Avila, CRNP
• Maines Larissa Aviles-Santa, M.D.
• Nathacha Avril
• Kanwal Shahzadi Awan, MD
• Pato Awate
• Debbie Awwad
• Memar D. Ayalew, PHARM.D.

• Family Nurse Practitioner in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.