Individual provider Active NPI

Nancy J Pittman, NP-C

  • Family Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1134550189
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F0913103 Issued in MS
Practice address
1801 Fairfield Ave Ste 408
Shreveport, LA 71101-4468
Phone
(318) 239-7045
Fax
(318) 585-0026
NPI assigned
Dec 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F0913103 MS Primary

Addresses

Primary practice location

1801 Fairfield Ave Ste 408
Shreveport, LA 71101-4468

Mailing address

PO Box 1089
Hammond, LA 70404-1089
Phone (985) 892-7070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150812006548 LA Practitioner - Nurse Practitioner 8527373166 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Urgent Care Center-PierremontGroup PAC ID 8123016946, 39 clinicians
Wound Care Associates LLCGroup PAC ID 0840314548, 117 clinicians

Practice addresses (Care Compare)

1666 E Bert Kouns Industrial Loop
Suite 105
Shreveport, LA 71105-5718
Phone (318) 212-3520

1801 Fairfield Ave
Suite 408
Shreveport, LA 71101-4468
Phone (985) 892-7070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F0913103MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Jun 3, 2017 Accepting new patients
WK Urgent Care Center-Pierremont CurrentSince Nov 4, 2022 Accepting new patients
Wound Care Associates LLC CurrentSince Mar 7, 2022 Accepting new patients
University Health Shreveport LLC CurrentSince Oct 7, 2019 Accepting new patients
WK Urgent Care Center - Bossier Past Accepting new patients

Locations

1001 Lackland Blvd
Ste 110
Benton, LA 71006
Phone (318) 935-1500

2300 Hospital Dr
Ste 180
Bossier City, LA 71111
Phone (318) 212-7520

5751 Shed Rd
Ste 100
Bossier City, LA 71111
Phone (318) 935-1900

20050 Crestwood Blvd
#O
Covington, LA 70433
Phone (985) 867-4008

16065 Lamonte Dr
Hammond, LA 70403
Phone (985) 956-7771

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1666 E Bert Kouns Industrial Loop
Ste 105
Shreveport, LA 71105
Phone (318) 212-3520

9460 Ellerbe Rd
Ste 140
Shreveport, LA 71106
Phone (318) 213-7070

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

1801 Fairfield Ave
Ste 408
Shreveport, LA 71101
Phone (318) 675-1322

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": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1134550189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1089",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704041089",
            "telephone_number": "985-892-7070",
            "fax_number": "985-892-7017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FAIRFIELD AVE STE 408",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014468",
            "telephone_number": "318-239-7045",
            "fax_number": "318-585-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "NANCY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "F0913103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.