Jackie Dale Hatten Jr., ARNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

ARNP3419772 Issued in FL

Practice address

500 N West Shore Blvd Ste 635
Tampa, FL 33609-1910

Phone

(813) 513-9493

Fax

(904) 562-3317

NPI assigned

Jun 1, 2017

Last updated

Oct 4, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Digestive Diseases Care for All LLC

  • Gastroenterology Physician
  • Lakeland, FL
  • NPI 1346484565
  Medicare reassignment NPD
• Comprehensive Psychiatric Associates LLC

  • Psychiatry Physician
  • Lakeland, FL
  • NPI 1457714834
  NPD (past)

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1639607732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N WEST SHORE BLVD STE 635",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091910",
            "telephone_number": "813-513-9493",
            "fax_number": "904-562-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N WEST SHORE BLVD STE 635",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336091910",
            "telephone_number": "813-513-9493",
            "fax_number": "904-562-3317"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1918 Blanding Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322103202",
            "country_code": "US",
            "telephone_number": "904-389-6954",
            "fax_number": "904-526-3317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATTEN",
        "first_name": "JACKIE",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-01",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP3419772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYER DOSE NOT TAKE INSURANCE",
            "identifier": "1639607732",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Hathcox, ARNP
• Jessica Marie Hathon, LMT
• Lashanna Hathorne, MBA-HA
• Hatikvah for Seniors
• Preston Joshua Hatlestad, M.D.
• Rachel Hatton
• Laura Y. Haubner, MD
• Dante Hauer
• Sandra Haueter
• Kara Ashley Haughey

• Adult Health Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.