Active NPI
Justin Lee Hartung, PA-C, MMS
- Physician Assistant
- Baton Rouge, LA
National Provider Identifier
1417266347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.200334.RX
- Practice address
- 13406 Airline Hwy
Baton Rouge, LA 70817-5917 - Phone
- (225) 753-7233
- Fax
- (225) 753-5188
- NPI assigned
- Sep 27, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.200334.RX | LA | Primary |
Addresses
Primary practice location
13406 Airline Hwy
Baton Rouge, LA 70817-5917
Mailing address
13406 Airline Hwy
Baton Rouge, LA 70817-5917
Phone (225) 753-7233
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PA.200334.RX | Other | LA | LOUISIANA LICENSE NUMBER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.200334.RX | LA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285545600000",
"number": "1417266347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13406 AIRLINE HWY",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708175917",
"telephone_number": "225-753-7233",
"fax_number": "225-753-5188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13406 AIRLINE HWY",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708175917",
"telephone_number": "225-753-7233",
"fax_number": "225-753-5188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTUNG",
"first_name": "JUSTIN",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "PA-C, MMS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-27",
"last_updated": "2010-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "LA",
"license": "PA.200334.RX",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOUISIANA LICENSE NUMBER",
"identifier": "PA.200334.RX",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.