Active NPI
Jean Grant Hawkins, MD FCCP
- Pulmonary Disease Physician
- Northridge, CA
National Provider Identifier
1043328750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- G43200
- Practice address
- 18546 Roscoe Blvd
#308
Northridge, CA 91324 - Phone
- (818) 349-2931
- Fax
- (818) 349-7930
- NPI assigned
- Aug 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | G43200 | CA | Primary |
Addresses
Primary practice location
18546 Roscoe Blvd
#308
Northridge, CA 91324
Mailing address
18546 Roscoe Blvd
#308
Northridge, CA 91324
Phone (818) 349-2931
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0005950 | Medicaid | CA | |
| G43200 | Other | STATE LICENSE | |
| 00G432000 | Other | BLUE CROSS BLUE SHIELD | |
| ZZZ90411Z | Other | BLUE CROSS BLUE SHIELD GR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G43200 | CA | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valley Pulmonary Medical Group | Pulmonary Disease | Current | Accepting new patients |
Locations
18546 Roscoe Blvd
Ste 308
Northridge, CA 91324
Phone (818) 349-2931
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043328750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18546 ROSCOE BLVD",
"address_2": "#308",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "91324",
"telephone_number": "818-349-2931",
"fax_number": "818-349-7930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18546 ROSCOE BLVD",
"address_2": "#308",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "91324",
"telephone_number": "818-349-2931",
"fax_number": "818-349-7930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWKINS",
"first_name": "JEAN",
"middle_name": "GRANT",
"credential": "MD FCCP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "CA",
"license": "G43200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0005950",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "G43200",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "00G432000",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD GR",
"identifier": "ZZZ90411Z",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.