Active NPI
Deborah A Hyatt, CRNP
- Family Nurse Practitioner
- Lucedale, MS
National Provider Identifier
1063428449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R865909
- Practice address
- 92 Ratliff St
Lucedale, MS 39452-6537 - Phone
- (601) 947-8181
- Fax
- (601) 947-4411
- NPI assigned
- Jul 31, 2006
- Last updated
- Apr 2, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-049783 | AL | |
| Family Nurse Practitioner | 363LF0000X | R865909 | MS | Primary |
Addresses
Primary practice location
92 Ratliff St
Lucedale, MS 39452-6537
Mailing address
PO Box 1007
Lucedale, MS 39452-1007
Phone (601) 947-8181
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 07739398 | Medicaid | MS | |
| 3979885804 | Other | MS | DOT ID# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R865909 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| George County Hospital | Current | Accepting new patients |
Interoperability endpoints
- deborahhyatt@grh.medalliesdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Rural Acute Care Hospital
- Lucedale, MS
- NPI 1023074028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396396800000",
"number": "1063428449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1007",
"city": "LUCEDALE",
"state": "MS",
"postal_code": "394521007",
"telephone_number": "601-947-8181",
"fax_number": "601-947-4411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92 RATLIFF ST",
"city": "LUCEDALE",
"state": "MS",
"postal_code": "394526537",
"telephone_number": "601-947-8181",
"fax_number": "601-947-4411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HYATT",
"first_name": "DEBORAH",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2014-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "1-049783",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R865909",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "07739398",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOT ID#",
"identifier": "3979885804",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lucedale, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.