Giavanna Lau, MD
Individual provider Active NPI Psychiatry Physician · Ft Riley, KS
NPI 1467444232 · NPPES record last updated Apr 2, 2013
Key facts
- NPI
- 1467444232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 22760 (NE)
- Practice address
- 600 Caisson Hill Rd
Irwin Army Community Hospital
Ft Riley, KS 66442-7037 - Phone
- (402) 469-0643
- NPI assigned
- Aug 18, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130415000341 | HI | Practitioner - Psychiatry | 7517949456 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22760 | NE | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Hawaii Department of Health | Psychiatry | Current |
Accepting new patients |
| Brighter Day Health LLC | Current |
Accepting new patients | |
| State of Hawaii Department of Health | Current |
Accepting new patients | |
| State of Hawaii, Department of Health | Current | Accepting new patients | |
| State of Nebraska Dept of Admin Services | Past | Accepting new patients | |
| Brighter Day Health LLC | Past |
Accepting new patients | |
| Hastings Community Psychiatry LLC | Psychiatry | Past |
Accepting new patients |
Locations
1830 Honoapiilani Hwy
Lahaina, HI 96761
Phone (808) 662-4031
2400 Augusta Dr
Ste 326
Houston, TX 77057
Phone (713) 344-1301
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 22760 | NE | Yes |
Addresses
Primary practice location
600 Caisson Hill Rd
Irwin Army Community Hospital
Ft Riley, KS 66442-7037
Mailing address
354 Olomana St
Kailua, HI 96734-2217
Phone (402) 469-0643
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04304 | Other | NE | BLUE CROSS BLUE SHIELD NE |
Other names
- Giavanna P Bouthiette
Other providers in Ft Riley, KS
- Jared Joseph Lampe
- John Robert Lane
- Gretchen Treat Larchick
- Lori M Larson
- Meredith Marie Lastra
- Emilea Lautner
- Stephen Andrew Lawson
- Tung Van Le
- Jennelle Lebeau
- June Lee
All providers in Ft Riley, KS · Psychiatry Physician in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.