Hawthorne Medical Center, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

HCC8421 Issued in FL

Legal business name

HAWTHORNE MEDICAL CENTER, INC.

Practice address

21815 S.E .71St Avenue
Hawthorne, FL 32640-3974

Phone

(352) 481-2400

Fax

(352) 481-2777

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Patricia O McCullough, RN COHN-S

Title

President/Owner

Phone

(352) 481-2400

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Hawthorne Medical Center, PA Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ona Colasante, MD

  • Family Medicine Physician
  • Gainesville, FL
  • NPI 1730160193
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1023196318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21815 S.E .71ST AVENUE",
            "city": "HAWTHORNE",
            "state": "FL",
            "postal_code": "326403974",
            "telephone_number": "352-481-2400",
            "fax_number": "352-481-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21815 S.E .71ST AVENUE",
            "city": "HAWTHORNE",
            "state": "FL",
            "postal_code": "326403974",
            "telephone_number": "352-481-2400",
            "fax_number": "352-481-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAWTHORNE MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "352-481-2400",
        "authorized_official_credential": "RN COHN-S"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME63062",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "HCC8421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37209S100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "45696",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "18622",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hawthorne Medical Center, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kaitlynne Nichole Goodman, CNA
• Grade a Nursing Services LLC
• Erin Stacey Hailstone, LMT
• Harmony Fruition Agency LLC
• Hawthorne Family Practice LLC
• Healthy Lifestyles, LLC
• Holiday CVS LLC
• Katherine Sue Hooper
• Nikki Nicole Hutchinson, CCC-SLP, MA
• Michelle Johnson

• Family Medicine Physician in Hawthorne, FL
• Providers in Hawthorne, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; 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.