Rosemarie V Lazo
Individual provider Active NPI Primary Care Nurse Practitioner · Independence, LA
NPI 1992351365 · NPPES record last updated Jan 31, 2020
Key facts
- NPI
- 1992351365
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 207597 (LA)
- Practice address
- 13318 Berry Bowl Rd
Independence, LA 70443-2363 - NPI assigned
- Aug 12, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 23
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southeast Community Health Systems
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190924000648 | LA | Practitioner - Nurse Practitioner | 0143550863 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 207597 | LA | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Community Health Systems | Current |
Accepting new patients | |
| Southeast Community Health Systems | Current |
Accepting new patients | |
| Southeast Community Health Systems | Current |
Accepting new patients | |
| Southeast Community Health Systems | Current | Accepting new patients |
Locations
490 Sitman St
Greensburg, LA 70441
Phone (225) 222-6059
30575 Old Baton Rouge Hwy
Hammond, LA 70403
Phone 22530620002045
336 E Railroad Ave
Independence, LA 70443
Phone (225) 306-2060
721 Avenue G
Kentwood, LA 70444
Phone (985) 229-5501
6351 Main St
Zachary, LA 70791
Phone (225) 306-2055
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 207597 | LA | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 207597 | Medicaid | LA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | 13318BerryBowlRoadIndependenceLA70443 |
Other providers in Independence, LA
- Lallie Kemp Medical Ctr
- Carl Phillip Lamprecht
- Lydia B Langer
- Judy K Larson
- Charlotte Lathers
- Shamekia Marie Lee
- Nicholas William Lewing
- Jasmine Capri Lewis
- Denise Maria Linton
- Little Italy Family Practice
All providers in Independence, LA · Primary Care Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.