Individual provider Active NPI

Laurie Ann Dennison, FNP-BC

  • Family Nurse Practitioner
  • Granville, NY
National Provider Identifier
1942653852
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F340660-1 Issued in NY
Practice address
15 Pine St
Granville, NY 12832-1111
Phone
(518) 955-8576
NPI assigned
Jul 15, 2016
Last updated
Jul 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F340660-1 NY Primary
Registered Nurse 163W00000X 403123-1 NY

Addresses

Primary practice location

15 Pine St
Granville, NY 12832-1111

Mailing address

15 Pine St
Granville, NY 12832-1111
Phone (518) 955-8576

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20160919000834 NY Practitioner - Nurse Practitioner 9739476805 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
403123-1NYMDRegistered Nurse
F340660-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Glens Falls Hospital Inc. CurrentSince Jun 1, 2019 Accepting new patients
Glens Falls Hospital Inc CurrentSince Jun 1, 2019 Accepting new patients
Irongate Family Practice Associates PLLC CurrentSince Sep 6, 2016 Accepting new patients

Locations

100 Park St
Glens Falls, NY 12801
Phone (518) 926-5924

3 Irongate Ctr
Glens Falls, NY 12801
Phone (518) 793-4409

79 North St
Granville, NY 12832
Phone (518) 642-0612

Interoperability endpoints

  • Direct secure messaging: lauried@irongatefamilypractice.medentdirect.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1942653852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PINE ST",
            "city": "GRANVILLE",
            "state": "NY",
            "postal_code": "128321111",
            "telephone_number": "518-955-8576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PINE ST",
            "city": "GRANVILLE",
            "state": "NY",
            "postal_code": "128321111",
            "telephone_number": "518-955-8576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNISON",
        "first_name": "LAURIE",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340660-1",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "403123-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granville, NY

Sources for this page

Verify at the official NPI Registry.