Individual provider Active NPI

Mary Kay Hartman, N.P.

  • Nurse Practitioner
  • Luling, LA
National Provider Identifier
1336132190
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Practice address
843 Milling Ave
Luling, LA 70070-4442
Phone
(985) 785-5800
Fax
(985) 785-5811
NPI assigned
Aug 26, 2005
Last updated
Jan 10, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X LA Primary

Addresses

Primary practice location

843 Milling Ave
Luling, LA 70070-4442

Mailing address

843 Milling Ave
Luling, LA 70070-4442
Phone (985) 785-5800

Other identifiers 1

IdentifierTypeStateIssuer
1551261MedicaidLA

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
46554-3120LAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1336132190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 MILLING AVE",
            "city": "LULING",
            "state": "LA",
            "postal_code": "700704442",
            "telephone_number": "985-785-5800",
            "fax_number": "985-785-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 MILLING AVE",
            "city": "LULING",
            "state": "LA",
            "postal_code": "700704442",
            "telephone_number": "985-785-5800",
            "fax_number": "985-785-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "MARY",
        "middle_name": "KAY",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1551261",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Luling, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.