Individual provider Active NPI

Mary Motley Hatchett, A-GNP

  • Adult Health Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1578544409
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
600053 Issued in NC
Practice address
10926 David Taylor Dr Ste 120S
Charlotte, NC 28262-1293
Phone
(336) 706-6614
Fax
(336) 450-1846
NPI assigned
Nov 8, 2005
Last updated
Apr 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 600053 NC Primary

Addresses

Primary practice location

10926 David Taylor Dr Ste 120S
Charlotte, NC 28262-1293

Mailing address

10926 David Taylor Dr Ste Suite120
Charlotte, NC 28262-1293
Phone (336) 706-6614

Other practice location 1

208 Bridford Downs Dr
Greensboro, NC 27407-2767
Phone (336) 706-2388

Other identifiers 3

IdentifierTypeStateIssuer
7000151MedicaidNC
600053OtherNCMEDICAL BOARD
096526OtherNCNURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040629001404 NC Practitioner - Nurse Practitioner 7012993959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10926 David Taylor Dr
Suite 120
Charlotte, NC 28262-0039
Phone (336) 706-6614

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Qofl Services LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGJIDD/Endpoint/HGJIDD

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1578544409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10926 DAVID TAYLOR DR STE SUITE120",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621293",
            "telephone_number": "336-706-6614",
            "fax_number": "336-450-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10926 DAVID TAYLOR DR STE 120S",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621293",
            "telephone_number": "336-706-6614",
            "fax_number": "336-450-1846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Bridford Downs Dr",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274072767",
            "country_code": "US",
            "telephone_number": "336-706-2388",
            "fax_number": "336-450-1846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATCHETT",
        "first_name": "MARY",
        "middle_name": "MOTLEY",
        "name_prefix": "Ms.",
        "credential": "A-GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "600053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000151",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD",
            "identifier": "600053",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING",
            "identifier": "096526",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.