Individual provider Active NPI

Otissicia Lateac Hill, RN, BSN

  • Family Nurse Practitioner
  • Benton, LA
National Provider Identifier
1760168082
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
212262 Issued in LA
Practice address
112 St Andrews LN
Benton, LA 71006-9446
Phone
(318) 272-5015
NPI assigned
Jun 22, 2023
Last updated
Jun 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X NU
Family Nurse Practitioner 363LF0000X 212262 LA Primary

Addresses

Primary practice location

112 St Andrews LN
Benton, LA 71006-9446

Mailing address

112 St Andrews LN
Benton, LA 71006-9446
Phone (318) 272-5015

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
I20260608004272 LA Practitioner - Nurse Practitioner 9638647563 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

112 St Andrews LN
Benton, LA 71006-9446

2015 E 70TH St
Suite a
Shreveport, LA 71105-5305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
212262LAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Family and Mental Health Clinic CurrentSince Aug 3, 2026 Accepting new patients
Heart of Louisiana Transportation Services Non-Emergency Medical Transport (Van) CurrentSince Jul 2, 2023 Accepting new patients

Locations

2015 E 70th St
Shreveport, LA 71105
Phone (318) 797-3505

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1760168082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 ST ANDREWS LN",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710069446",
            "telephone_number": "318-272-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 ST ANDREWS LN",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710069446",
            "telephone_number": "318-272-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "OTISSICIA",
        "middle_name": "LATEAC",
        "credential": "RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "212262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, LA

Sources for this page

Verify at the official NPI Registry.