Individual provider Active NPI

Kristin Attaway, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1265900039
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
200720 Issued in LA
Practice address
302 W McNeese St
Lake Charles, LA 70605-5604
Phone
(337) 991-9276
NPI assigned
Nov 9, 2018
Last updated
Nov 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 200720 LA Primary

Addresses

Primary practice location

302 W McNeese St
Lake Charles, LA 70605-5604

Mailing address

1509 Dulles Dr
Lafayette, LA 70506-3718
Phone (337) 991-9276

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
I20181204001725 LA Practitioner - Nurse Practitioner 6507100401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oceans Rog LLCGroup PAC ID 1355566712, 8 clinicians

Practice addresses (Care Compare)

302 W McNeese St
Lake Charles, LA 70605-5604
Phone (337) 474-7581

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200720LAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oceans Rog LLC Psychiatric/Mental Health CurrentSince Nov 19, 2018 Accepting new patients
Oceans Rog LLC Psychiatric/Mental Health Current Accepting new patients
Oceans Behavioral Hospital of Greater New Orleans LLC PastSince Jan 17, 2022 Accepting new patients

Locations

229 Bellemeade Blvd
Gretna, LA 70056
Phone (504) 391-2440

302 W McNeese St
Lake Charles, LA 70605
Phone (337) 210-1207

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1265900039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705063718",
            "telephone_number": "337-991-9276",
            "fax_number": "337-943-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055604",
            "telephone_number": "337-991-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTAWAY",
        "first_name": "KRISTIN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-09",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "200720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.