Individual provider Active NPI

Lizabeth G Hattaway, APRN FNP-C

  • Family Nurse Practitioner
  • Leesville, LA
National Provider Identifier
1942223904
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN054182 AP04763 Issued in LA
Practice address
506 S 6TH St
Leesville, LA 71446-4482
Phone
(337) 239-2234
Fax
(337) 392-9383
NPI assigned
Jul 25, 2006
Last updated
Jan 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN054182 AP04763 LA Primary

Addresses

Primary practice location

506 S 6TH St
Leesville, LA 71446-4482

Mailing address

506 S 6TH St
Leesville, LA 71446-4482
Phone (337) 239-2234

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050921000063 LA Practitioner - Nurse Practitioner 1951335884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CLHG-LeesvilleGroup PAC ID 4082963301, 25 clinicians

Practice addresses (Care Compare)

427 N Pine St
Byrd Walk in Clinic
Deridder, LA 70634-3905
Phone (337) 462-6471

506 S 6TH St
Byrd Medical Clinic
Leesville, LA 71446-4482
Phone (337) 239-0989

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN054182 AP04763LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CLHG-Leesville CurrentSince May 16, 2020 Accepting new patients
CLHG-Leesville Current Accepting new patients
CLHG-Leesville CurrentSince May 16, 2020 Accepting new patients
Jackson Parish Hospital Past Accepting new patients
Byrd Medical Clinic Inc Past Accepting new patients
Jackson Parish Hospital Past Accepting new patients

Locations

412 S Pine St
Deridder, LA 70634
Phone (337) 462-5700

427 N Pine St
Deridder, LA 70634
Phone (337) 239-0989

1020 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-5278

506 S 6th St
Leesville, LA 71446
Phone (337) 239-0989

927 Verone Ter
Leesville, LA 71446
Phone (337) 238-1049

Interoperability endpoints

  • Direct secure messaging: lizabeth.hattaway.1@17837.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1942223904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 S 6TH ST",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464482",
            "telephone_number": "337-239-2234",
            "fax_number": "337-392-9383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 S 6TH ST",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464482",
            "telephone_number": "337-239-2234",
            "fax_number": "337-392-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATTAWAY",
        "first_name": "LIZABETH",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "APRN FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN054182 AP04763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.