Laura S Reaves

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

APN 5635 Issued in TN

Practice address

306 W Due West Ave
Madison, TN 37115-4511

Phone

(615) 673-6737

NPI assigned

Jun 26, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1942237292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 WHITE BRIDGE RD # 103-243",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372051444",
            "telephone_number": "615-673-6737",
            "fax_number": "615-296-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W DUE WEST AVE",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371154511",
            "telephone_number": "615-673-6737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAVES",
        "first_name": "LAURA",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "APN 5635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3344277",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Madison, TN
• Providers in Madison, TN by specialty
• Gerontology Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.