Individual provider Active NPI

Jack Hitchens, AU.D.

  • Audiologist
  • Dalton, GA
National Provider Identifier
1033403696
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
1436 Chattanooga Ave
Dalton, GA 30720-2637
Phone
(706) 279-3277
NPI assigned
Jun 1, 2011
Last updated
Jun 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X NU Primary

Addresses

Primary practice location

1436 Chattanooga Ave
Dalton, GA 30720-2637

Mailing address

1040 E Lakeshore Dr
Dalton, GA 30720-5273

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110726000029 GA Practitioner - Qualified Audiologist 6103094727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of North Carolina at Chapel Hill School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1436 Chattanooga Ave
Dalton, GA 30720-2637
Phone (706) 226-2142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dalton Ear Nose & Throat Associates CurrentSince Jun 28, 2011 Accepting new patients
Dalton Ear Nose & Throat Associates CurrentSince Jun 28, 2011 Accepting new patients

Locations

705 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 629-1852

1436 Chattanooga Ave
Dalton, GA 30720
Phone (706) 226-2142

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7297/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jack.hitchens.1@7297.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1033403696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 E LAKESHORE DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307205273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 CHATTANOOGA AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202637",
            "telephone_number": "706-279-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITCHENS",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.