Individual provider Active NPI

Lavetta Hutchinson, NP

  • Nurse Practitioner
  • Gary, WV
National Provider Identifier
1366513228
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
38044 Issued in WV
Practice address
Route 103 Supply Street
Gary, WV 24836-0507
Phone
(304) 448-2101
Fax
(304) 448-3217
NPI assigned
Nov 13, 2006
Last updated
Sep 20, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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 38044 WV Primary

Addresses

Primary practice location

Route 103 Supply Street
Gary, WV 24836-0507

Mailing address

221 Stewart St
Welch, WV 24801-2027

Other identifiers 1

IdentifierTypeStateIssuer
3810011595MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38044WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Associates, Inc Past Accepting new patients
Tug River Health Association, Inc Past Accepting new patients
Tug River Health Association, Inc Past Accepting new patients

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284940800000",
    "number": "1366513228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 STEWART ST",
            "city": "WELCH",
            "state": "WV",
            "postal_code": "248012027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 103 SUPPLY STREET",
            "city": "GARY",
            "state": "WV",
            "postal_code": "248360507",
            "telephone_number": "304-448-2101",
            "fax_number": "304-448-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "LAVETTA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2010-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "38044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810011595",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, WV

Sources for this page

Verify at the official NPI Registry.