Individual provider Active NPI

Hannah W Jeane, PA

  • Physician Assistant
  • Hot Springs, AR
National Provider Identifier
1053922443
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PT2022-015 Issued in AR
Practice address
1 Mercy LN Ste 401
Hot Springs, AR 71913-6441
Phone
(501) 623-5220
NPI assigned
Aug 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PT2022-015 AR Primary

Addresses

Primary practice location

1 Mercy LN Ste 401
Hot Springs, AR 71913-6441

Mailing address

17825 Cullipher LN
Little Rock, AR 72206-9550
Phone (318) 308-8436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, LA2 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
I20220330000165 AR Practitioner - Physician Assistant 4789070822 Reassigns benefits to 1 organization
I20260527000862 LA Practitioner - Physician Assistant 4789070822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1701 Oak Park Blvd
Lake Charles, LA 70601-8911

4100 International PLZ
Fort Worth, TX 76109-4800

Hospital & facility affiliations

  • Lake Charles Memorial Hospital Hospital, Lake Charles, LA, CCN 190060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1053922443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17825 CULLIPHER LN",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722069550",
            "telephone_number": "318-308-8436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MERCY LN STE 401",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719136441",
            "telephone_number": "501-623-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANE",
        "first_name": "HANNAH",
        "middle_name": "W",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AR",
            "license": "PT2022-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, AR

Sources for this page

Verify at the official NPI Registry.