Karl Hatten, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

12505 Issued in MS

Practice address

969 Lakeland Dr
Emergency Department
Jackson, MS 39216-4606

Phone

(601) 200-6175

Fax

(601) 200-2020

NPI assigned

Jun 9, 2006

Last updated

Jun 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• St. Dominic Jackson Memorial

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1235173691
  Authorized official Same address or phone

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1912948894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23457",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392253457",
            "telephone_number": "601-200-6175",
            "fax_number": "601-200-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 LAKELAND DR",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164606",
            "telephone_number": "601-200-6175",
            "fax_number": "601-200-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATTEN",
        "first_name": "KARL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "12505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110612",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014778",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marnisha Hatch
• Arlin George Hatfield III, MD
• Mary Hathorn, MS
• Stephanie Anne Hathorn
• Vicki Helene Hathorn, NP
• Margaret Thurber Hatten, M.D.
• Hattiesburg Road Dental, P.C. (Kool Smiles)
• Hattiesburg Road Dental, P.C. (Sunnybrook Dentistry)
• Logan Sears Havard, MD
• Eric Haver, ATC, LAT, MHSA

• Emergency Medicine Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Emergency Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.