Organization Active NPI

Dillon Hart Acnp, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1922475227
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
DILLON HART ACNP, LLC
Practice address
1800 Irving Place
Shreveport, LA 71101
Phone
(318) 458-3857
Fax
(318) 929-2918
NPI assigned
Aug 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Authorized official

Name
Dillon Harris Hart, NPNPI 1457681850
Title
President/Owner
Phone
(318) 458-3857

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

1800 Irving Place
Shreveport, LA 71101

Mailing address

PO Box 5234
Bossier City, LA 71171-5234
Phone (318) 458-3857

Other identifiers 1

IdentifierTypeStateIssuer
1814393MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151109002124 LA Part B Supplier - Clinic/Group Practice 5496065179 Receives reassigned benefits from 1 practitioner
Practice locations: Bossier City, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1440201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1922475227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5234",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711715234",
            "telephone_number": "318-458-3857",
            "fax_number": "318-314-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 IRVING PLACE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71101",
            "telephone_number": "318-458-3857",
            "fax_number": "318-929-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DILLON HART ACNP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-22",
        "last_updated": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "DILLON",
        "authorized_official_middle_name": "HARRIS",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "318-458-3857",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1814393",
            "state": "LA"
        }
    ],
    "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 Oct 5, 2023; 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.