Connie Hale, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP03832 Issued in LA

Practice address

3018 Old Minden Rd Ste 1117
Bossier City, LA 71112-2497

Phone

(318) 746-1935

Fax

(318) 746-2514

NPI assigned

Feb 28, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

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

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 and National Provider Directory roles.

• Brentwood Acquisition-Shreveport Inc.

  • Psychiatry Physician
  • Shreveport, LA
  • NPI 1164725701

  Psychiatric Hospital

  Medicare reassignment NPD
• Brentwood Acquisition-Shreveport Inc.

  • Psychiatric Hospital
  • Shreveport, LA
  • NPI 1417979204
  NPD

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1790751642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 PICCADILLY CIR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711117127",
            "telephone_number": "318-422-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3018 OLD MINDEN RD STE 1117",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711122497",
            "telephone_number": "318-746-1935",
            "fax_number": "318-746-2514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "CONNIE",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "LA",
            "license": "AP03832",
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "LA",
            "license": "AP03832",
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "LA",
            "license": "AP03832",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP03832",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "AP03832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1189537",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guidco Medical, LLC
• Lionel Guillaume, M.D.
• Samantha Guyton
• H.O.P.E. Intergrative Community Support Services
• Rachel Elizabeth Halbrook
• Daniel Gordon Hale
• Kyesha Hall-Moreaux
• Robin Hall
• Jennifer G Hamer, D.C.
• Nathan Andrew Hamer, D.C.

• Psychiatric/Mental Health Nurse Practitioner in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.