Active NPI
Joseph Hathorn, MD
- Emergency Medicine Physician
- Alexandria, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- M6179
- Practice address
- 3330 Masonic Dr
Alexandria, LA 71301-3841 - Phone
- (800) 639-2519
- Fax
- (985) 447-8556
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 13632R | LA | |
| Emergency Medicine Physician | 207P00000X | M6179 | TX | Primary |
Addresses
Primary practice location
3330 Masonic Dr
Alexandria, LA 71301-3841
Mailing address
PO Box 12670
Alexandria, LA 71315-2670
Phone (800) 639-2519
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1435279 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070927001063 | TX | Practitioner - Emergency Medicine | 6901807577 | Reassigns benefits to 2 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13632R | LA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Travis County Emergency Physicians PA | Emergency Medicine | Current | Accepting new patients |
| Memorial Southwest Emergency Physicians, LLP | Emergency Medicine | Past | Accepting new patients |
| Woodlands Emergency Physicians, LLP | Emergency Medicine | Past | Accepting new patients |
| ER Medical Services, Inc. | Emergency Medicine | Past | Accepting new patients |
Locations
7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305
2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779
6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000
1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050
11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020
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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205193600000",
"number": "1073545588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12670",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713152670",
"telephone_number": "800-639-2519",
"fax_number": "985-447-8556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3330 MASONIC DR",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713013841",
"telephone_number": "800-639-2519",
"fax_number": "985-447-8556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATHORN",
"first_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2008-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "LA",
"license": "13632R",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "TX",
"license": "M6179",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1435279",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Alexandria, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.