Organization Active NPI

Lotus Healthcare and Aesthetics LLC

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1770154627
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LOTUS HEALTHCARE AND AESTHETICS LLC
Practice address
340 W 23Rd St
Panama City, FL 32405-7600
Phone
(850) 628-0711
NPI assigned
Jul 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Authorized official

Name
Mrs. Lindsay May Hetrick, APRN
Title
Owner/ Aprn
Phone
(850) 628-0711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

340 W 23Rd St
Panama City, FL 32405-7600

Mailing address

340 W 23Rd St
Panama City, FL 32405-7600
Phone (850) 628-0711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210714002679 FL Part B Supplier - Clinic/Group Practice 4385046242 Receives reassigned benefits from 2 practitioners
Practice locations: Panama City, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1770154627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057600",
            "telephone_number": "850-628-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W 23RD ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324057600",
            "telephone_number": "850-628-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTUS HEALTHCARE AND AESTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "HETRICK",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_middle_name": "MAY",
        "authorized_official_title_or_position": "OWNER/ APRN",
        "authorized_official_telephone_number": "850-628-0711",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.