Individual provider Active NPI

Joseph Hathorn, MD

  • Emergency Medicine Physician
  • Alexandria, LA
National Provider Identifier
1073545588
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M6179 Issued in TX
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

Updated by the provider on Mar 11, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1435279MedicaidLA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
13632RLAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Oct 3, 2023 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.

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

Verify at the official NPI Registry.