Individual provider Active NPI

Rosemarie V Lazo

  • Primary Care Nurse Practitioner
  • Independence, LA
National Provider Identifier
1992351365
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
207597 Issued in LA
Practice address
13318 Berry Bowl Rd
Independence, LA 70443-2363
NPI assigned
Aug 12, 2019
Last updated
Jan 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 207597 LA Primary

Addresses

Primary practice location

13318 Berry Bowl Rd
Independence, LA 70443-2363

Mailing address

13318 Berry Bowl Rd
Independence, LA 70443-2363
Phone (225) 306-2064

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 13318BerryBowlRoadIndependenceLA70443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20190924000648 LA Practitioner - Nurse Practitioner 0143550863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast Community Health SystemsGroup PAC ID 4284610437, shared by 23 NPIs, 22 clinicians

Practice addresses (Care Compare)

30575 Old Baton Rouge Hwy
Hammond, LA 70403-8350
Phone 22530620672045

336 E Railroad Ave
Independence, LA 70443-2710
Phone (225) 306-2067

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Community Health Systems Current Accepting new patients
Southeast Community Health Systems CurrentSince Sep 1, 2019 Accepting new patients
Southeast Community Health Systems CurrentSince Sep 1, 2019 Accepting new patients
Southeast Community Health Systems CurrentSince Sep 1, 2019 Accepting new patients
Southeast Community Health Systems PastSince Aug 18, 2019 Accepting new patients

Locations

490 Sitman St
Greensburg, LA 70441
Phone (225) 222-6059

30575 Old Baton Rouge Hwy
Hammond, LA 70403
Phone (225) 306-2050

336 E Railroad Ave
Independence, LA 70443
Phone (225) 306-2060

721 Avenue G
Kentwood, LA 70444
Phone (225) 306-2023

6351 Main St
Zachary, LA 70791
Phone (225) 206-4168

Organizations & group practices 5

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1992351365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13318 BERRY BOWL RD",
            "city": "INDEPENDENCE",
            "state": "LA",
            "postal_code": "704432363",
            "telephone_number": "225-306-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13318 BERRY BOWL RD",
            "city": "INDEPENDENCE",
            "state": "LA",
            "postal_code": "704432363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZO",
        "first_name": "ROSEMARIE",
        "middle_name": "V",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "LA",
            "license": "207597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "13318BerryBowlRoadIndependenceLA70443",
            "affiliation": "N",
            "address_1": "13318 Berry Bowl Rd",
            "city": "Independence",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704432363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Independence, LA

Sources for this page

Verify at the official NPI Registry.