Individual provider Active NPI

Laura Lee Henrikson, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1962087726
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP61120717 Issued in WA
Practice address
9201 E Mountain View Rd Ste 220
Scottsdale, AZ 85258-5172
Phone
(480) 271-3774
NPI assigned
Mar 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP61120717 WA
Primary Care Nurse Practitioner 363LP2300X AP61120717 WA Primary

Addresses

Primary practice location

9201 E Mountain View Rd Ste 220
Scottsdale, AZ 85258-5172

Mailing address

42 Sayward LN
Port Ludlow, WA 98365-9640
Phone (646) 753-1695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240412003781 ID Practitioner - Nurse Practitioner 6002255858 Reassigns benefits to 1 organization
I20260114003045 GA Practitioner - Nurse Practitioner 6002255858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

42 Sayward LN
Port Ludlow, WA 98365-9640

424 Church St
Nashville, TN 37219-2301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP61120717WAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Health Network LLC Nurse Practitioner CurrentSince Mar 2, 2024 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1000 Parkwood Cir SE
Ste 900
Atlanta, GA 30339
Phone (216) 393-8684

3597 E Monarch Sky Ln
Ste 240
Meridian, ID 83646
Phone (208) 996-3519

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1962087726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 SAYWARD LN",
            "city": "PORT LUDLOW",
            "state": "WA",
            "postal_code": "983659640",
            "telephone_number": "646-753-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 E MOUNTAIN VIEW RD STE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852585172",
            "telephone_number": "480-271-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIKSON",
        "first_name": "LAURA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-13",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP61120717",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP61120717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.