Jessica Hagan
Individual provider Active NPI Family Nurse Practitioner · Rayville, LA
NPI 1265039366 · NPPES record last updated Jun 16, 2023
Key facts
- NPI
- 1265039366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 213888 (LA)
- Practice address
- 111 Christian Dr
Rayville, LA 71269-3658 - Phone
- (318) 728-4400
- Fax
- (318) 728-4430
- NPI assigned
- Oct 2, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Guardian Health Clinic, LLC
Practice addresses (Care Compare)
111 Christian Dr
Rayville, LA 71269-3658
Phone (318) 728-4400
Hospital & facility affiliations
- Richardson Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201014003922 | LA | Practitioner - Nurse Practitioner | 6406276328 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lsu Health Sciences Center Shreveport Faculty Group Practice | Current |
Accepting new patients | |
| Brfhh Monroe LLC | Current |
Accepting new patients | |
| Brfhh Monroe LLC | Current |
Accepting new patients | |
| Guardian Health Clinic, LLC | Current |
Accepting new patients | |
| University Health Shreveport LLC | Nurse Practitioner | Current |
Accepting new patients |
Locations
4864 Jackson St
Monroe, LA 71202
Phone (318) 330-7000
111 Christian Dr
Rayville, LA 71269
Phone (318) 728-3263
1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402
1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177
1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 213888 | LA | Yes |
Addresses
Primary practice location
111 Christian Dr
Rayville, LA 71269-3658
Mailing address
111 Christian Dr
Rayville, LA 71269-3658
Phone (318) 728-4400
Other practice location 1
4864 Jackson St
Monroe, LA 71202-6400
Phone (318) 330-7000
Other providers in Rayville, LA
- Ariel Del Rio Graham
- Ramona Grayson
- Pamela Denise Green
- Pearley Grimes
- Guardian Health Clinic, LLC
- Carmel Haring
- Michelle Latessa Harrell Pippins
- Thomas Pipes Heath
- William Tyler Heath
- Eric Hendrix
All providers in Rayville, LA · Family Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.