Individual provider Active NPI

Katelyn Wyatt Pine, BA

  • Case Manager/Care Coordinator
  • Shreveport, LA
National Provider Identifier
1841016516
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2100 E 70TH St Ste a
Shreveport, LA 71105-5363
Phone
(318) 227-4999
NPI assigned
Nov 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

2100 E 70TH St Ste a
Shreveport, LA 71105-5363

Mailing address

1125 Windham CT
Bossier City, LA 71112-3198
Phone (318) 265-4155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Hands of Hope Behavioral Health, LLC. CurrentSince Dec 1, 2024 Accepting new patients
Hands of Hope Behavior Health Case Manager/Care Coordinator CurrentSince Dec 1, 2024 Accepting new patients

Locations

2100 E 70th St
Ste A
Shreveport, LA 71105
Phone (318) 227-4999

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": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1841016516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 WINDHAM CT",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711123198",
            "telephone_number": "318-265-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E 70TH ST STE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055363",
            "telephone_number": "318-227-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINE",
        "first_name": "KATELYN",
        "middle_name": "WYATT",
        "name_prefix": "Mrs.",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.