MRS. LAURA ICENHOUR BUCHANAN (NPI# 1780035816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780035816 |
| Entity Type | Individual |
| Full Name | MRS. LAURA ICENHOUR BUCHANAN |
| Credential | PA-C |
| Practice Address |
10628 Park Rd Charlotte NC 28210-8407 |
| Mailing Address |
125 W Tremont Ave Unit 612 Charlotte NC 28203-5518 |
| Practice Telephone | 7046671188 |
| Mailing Telephone | 7049892476 |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2018-11-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
0010-06582 | NC | Allopathic & Osteopathic Physicians |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1780035816 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1511 Sweetgum Ln, Matthews, NC 281050895 | 7049892476 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942442140 | Laura Ashley Buchanan | Internal Medicine | 914 N Dixie Ave Ste 302, Elizabethtown, KY 42701-2515 | 2009-04-02 |
| 1871054411 | Laura Ashford Buchanan | Student in an Organized Health Care Education/Training Program | 1920 W 1st St Fl 3, Winston Salem, NC 27104-4220 | 2019-03-27 |
| 1033554068 | Laura Elizabeth Buchanan | Optometrist | 5500 Main St Ste 102, Williamsville, NY 14221-6737 | 2013-05-03 |
| 1114201324 | Laura Buchanan | Pharmacist | 414 N Main St, Moscow, ID 83843-2631 | 2011-10-06 |
| 1609073923 | Laura Susan Buchanan | Surgery | 22 S Greene St, Baltimore, MD 21201-1544 | 2007-06-29 |
| Street Address |
10628 PARK RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28210-8407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861499279 | Rajesh Sakala | Hospitalist | 10628 Park Rd, Charlotte, NC 28210-8407 | 2005-06-30 |
| 1891393088 | Kedesse Yemane | Nurse Practitioner | 10628 Park Rd, Charlotte, NC 28210-8407 | 2020-10-11 |
| 1922628379 | Lisa Land | Registered Nurse | 10628 Park Rd, Charlotte, NC 28210-8407 | 2020-04-24 |
| 1427687888 | Marina Maystruk | Registered Nurse | 10628 Park Rd, Charlotte, NC 28210-8407 | 2020-04-07 |
| 1346889649 | Reinaldo Livoti | Physician Assistant | 10628 Park Rd, Charlotte, NC 28210-8407 | 2020-01-03 |
| 1407495385 | Garrett West | Registered Nurse | 10628 Park Rd, Charlotte, NC 28210-8407 | 2019-12-25 |
| 1497304927 | Jordan Felsberg | Physical Medicine & Rehabilitation | 10628 Park Rd, Charlotte, NC 28210-8407 | 2019-09-07 |
| 1740848100 | Carolinas Physicians Network Inc | Obstetrics & Gynecology | 10628 Park Rd, Charlotte, NC 28210-8407 | 2019-05-31 |
| 1568923803 | Elizabeth Curtis | Physician Assistant | 10628 Park Rd, Charlotte, NC 28210-8407 | 2019-03-28 |
| 1831669274 | Danielle Jennifer Giglio | Registered Nurse | 10628 Park Rd, Charlotte, NC 28210-8407 | 2018-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952920860 | Rx Care 14 LLC | Pharmacy | 7701 Sharon Lakes Road, Suite H, Charlotte, NC 28210 | 2020-04-10 |
| 1427697622 | David Durant Dinsmore | Nurse Anesthetist, Certified Registered | Atrium Health Pineville, 10628 Park Road, Charlotte, NC 28210 | 2020-01-06 |
| 1790256964 | Tele Phys Inc | Internal Medicine | 10035 Park Center Dr., Ste 100, Charlotte, NC 28210 | 2018-12-16 |
| 1104395896 | Bridgett Williams | Behavior Technician | 7806 Andover Woods Drive, Charlotte, NC 28210 | 2018-11-26 |
| 1053880518 | Low-t Physicians Professional Association | Internal Medicine | 10430 Park Road Suite 100a, Charlotte, NC 28210 | 2018-11-14 |
| 1053895102 | Carolinas Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 7701 Sharon Lakes Blvd, Ste A., Charlotte, NC 28210 | 2018-09-24 |
| 1679066658 | Afc Urgent Care and Family Care of Wnc, Pllc | Clinic/Center | 10102 Johnston Rd, Charlotte, NC 28210 | 2018-06-13 |
| 1346777018 | Hopeway Foundation | Clinic/Center | 1717 Sharon Road West, Charlotte, NC 28210 | 2017-05-12 |
| 1891154688 | Jessie Lee Ogienko | Social Worker | 5960 Fairview Rd Ste 328, Charlotte, NC 28210 | 2016-02-22 |
| 1699151985 | Carolina Complete Psychiatry, Pllc | Physician Assistant | 5950 Fairview Road, Suite 708, Charlotte, NC 28210 | 2015-08-10 |
| Find all providers in zip 28210 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376980417 | Beatty Medical Consulting, PC | Emergency Medicine | 9507 Brandemere Ct, Charlotte, NC 28210-1027 | 2013-05-30 |
| 1417916271 | Richard Lequeux Bradner | Emergency Medicine | 9720 S Tryon St, Charlotte, NC 28273-6578 | 2006-03-21 |
| 1801829379 | Ekachai Lucktong | Emergency Medicine | 3101 Latrobe Dr, Charlotte, NC 28211-4849 | 2006-07-08 |
| 1558397778 | Nadine Lettman-carswell | Emergency Medicine | 3101 Latrobe Dr, Charlotte, NC 28211-4849 | 2006-06-23 |
| 1972547834 | Julie O'sullivan | Emergency Medicine | 3101 Latrobe Dr, Charlotte, NC 28211-4849 | 2006-06-15 |
| 1033157318 | Jason Bolden | Emergency Medicine | 3101 Latrobe Dr, Charlotte, NC 28211-4849 | 2006-06-02 |
| 1477524460 | Steven Justus | Emergency Medicine | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2006-01-30 |
| 1760453070 | Ryan Hines | Emergency Medicine | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2006-01-27 |
| 1437139391 | Jennifer E Thompson | Emergency Medicine | 10628 Park Rd, Charlotte, NC 28210-8407 | 2006-01-18 |
| 1447239835 | Michael Frye | Emergency Medicine | 8800 N Tryon St, Charlotte, NC 28262-3300 | 2006-01-13 |
| Find all providers in CHARLOTTE | ||||
Please comment or provide details below to improve the information on MRS. LAURA ICENHOUR BUCHANAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.