NPIMap

Individual provider Active NPI

Danielle Lita Cloutier, PA-C

  • Physician Assistant
  • Cherokee, NC
National Provider Identifier
1093717209
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102766 Issued in NC
Practice address
1 Hospital Road
Caller Box C-268
Cherokee, NC 28719-9253
Phone
(828) 497-9163
Fax
(828) 497-1723
NPI assigned
Jun 1, 2005
Last updated
Apr 12, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 102766 NC Primary
Surgical Physician Assistant 363AS0400X 102766 NC

Addresses

Primary practice location

1 Hospital Road
Caller Box C-268
Cherokee, NC 28719-9253

Mailing address

1 Hospital Road
Caller Box C-268
Cherokee, NC 28719-9253
Phone (828) 497-9163

Other identifiers 2

IdentifierTypeStateIssuer
155VAOtherNCBCBS
1093717209MedicaidNC

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
102766NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Emergency Physicians, PLLC Past Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1093717209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL ROAD",
            "address_2": "CALLER BOX C-268",
            "city": "CHEROKEE",
            "state": "NC",
            "postal_code": "287199253",
            "telephone_number": "828-497-9163",
            "fax_number": "828-497-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL ROAD",
            "address_2": "CALLER BOX C-268",
            "city": "CHEROKEE",
            "state": "NC",
            "postal_code": "287199253",
            "telephone_number": "828-497-9163",
            "fax_number": "828-497-1723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUTIER",
        "first_name": "DANIELLE",
        "middle_name": "LITA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102766",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "102766",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "155VA",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093717209",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.