Active NPI
Otissicia Lateac Hill, RN, BSN
- Family Nurse Practitioner
- Benton, LA
National Provider Identifier
1760168082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 212262
- Practice address
- 112 St Andrews LN
Benton, LA 71006-9446 - Phone
- (318) 272-5015
- NPI assigned
- Jun 22, 2023
- Last updated
- Jun 25, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 212262 | LA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peace of Mind Family and Mental Health Clinic | Current | Accepting new patients | |
| Heart of Louisiana Transportation Services | Non-Emergency Medical Transport (Van) | Current | 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.
-
- Non-emergency Medical Transport (VAN)
- Benton, LA
- NPI 1629754544
-
- Family Medicine Physician
- Shreveport, LA
- NPI 1104751411
-
- Family Medicine Physician
- Shreveport, LA
- NPI 1962970582
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.