Individual provider Active NPI

Nicole R. Hutson Simone, APRN, CPNP

  • Pediatric Nurse Practitioner
  • Hammond, LA
National Provider Identifier
1710006481
Registry record updated Nov 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP04664 Issued in LA
Practice address
15756 Medical Arts Dr
Hammond, LA 70403-1446
Phone
(985) 318-6599
Fax
(985) 318-1386
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP04664 LA Primary
Pediatric Nurse Practitioner 363LP0200X R887980 MS

Addresses

Primary practice location

15756 Medical Arts Dr
Hammond, LA 70403-1446

Mailing address

PO Box 2668
Business Ctr - Ins Credentialing
Hammond, LA 70404-2668
Phone (985) 230-1682

Other identifiers 2

IdentifierTypeStateIssuer
06179048MedicaidMS
1722961MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20241126004311 LA Practitioner - Nurse Practitioner 3274068382 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP04664LAMDPediatric Nurse Practitioner
R887980MSMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Oaks Medical Center, LLC CurrentSince Jun 1, 2025 Accepting new patients
North Oaks Physician Group, LLC CurrentSince Dec 29, 2024 Accepting new patients

Locations

15695 Professional Plz
Hammond, LA 70403
Phone (985) 542-2599

15756 Medical Arts Dr
Hammond, LA 70403
Phone (985) 318-6599

42440 Pelican Professional Park
Hammond, LA 70403
Phone (985) 542-4950

15813 Paul Vega Md Dr
Ste 200
Hammond, LA 70403
Phone (985) 230-7650

15790 Paul Vega Md Dr
Hammond, LA 70403
Phone (985) 230-1682

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731715200000",
    "number": "1710006481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2668",
            "address_2": "BUSINESS CTR - INS CREDENTIALING",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704042668",
            "telephone_number": "985-230-1682",
            "fax_number": "985-230-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15756 MEDICAL ARTS DR",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031446",
            "telephone_number": "985-318-6599",
            "fax_number": "985-318-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTSON SIMONE",
        "first_name": "NICOLE",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "APRN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2024-11-16",
        "certification_date": "2024-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "AP04664",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "R887980",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06179048",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1722961",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.