Individual provider Active NPI

Dustin Hatten

  • Physical Therapist
  • Shreveport, LA
National Provider Identifier
1295621928
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11171 Issued in LA
Practice address
149 College St
Shreveport, LA 71104-2507
Phone
(318) 594-0766
NPI assigned
Jun 17, 2025
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11171 LA Primary

Addresses

Primary practice location

149 College St
Shreveport, LA 71104-2507

Mailing address

149 College St
Shreveport, LA 71104-2507

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250714003107 LA Practitioner - Physical Therapist in Private Practice 9133634603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glory Rehab Services LLCGroup PAC ID 6608211560, 5 clinicians

Practice addresses (Care Compare)

237 Brothers Rd
Scott, LA 70583-4809
Phone (318) 240-4758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11171LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Glory Rehab Services LLC Physical Therapist CurrentSince Jun 1, 2025 Accepting new patients

Locations

4955 N Market St
Shreveport, LA 71107
Phone (318) 240-4758

Organizations & group practices 1

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": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1295621928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 COLLEGE ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 COLLEGE ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042507",
            "telephone_number": "318-594-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATTEN",
        "first_name": "DUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "11171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.