Individual provider Active NPI

Suzanne L Hawkins, DO

  • Family Medicine Physician
  • Jber, AK
National Provider Identifier
1043334832
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101010048 Issued in MI
Practice address
5955 Zeamer Ave
Jber, AK 99506
Phone
(907) 580-8303
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101010048 MI Primary

Addresses

Primary practice location

5955 Zeamer Ave
Jber, AK 99506

Mailing address

16708 James St
Holland, MI 49424-6043
Phone (616) 550-9467

Other practice location 1

16708 James St
Holland, MI 49424-6043
Phone (616) 786-0011

Other practice location 2

16708 James St
Holland, MI 49424-6043
Phone (616) 786-0011

Other practice location 3

13320 N Blvd
Vicksburg, MI 49097-1514
Phone (269) 649-2012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060208000296 MI Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 2860407194 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101010048MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Methodist Hospital CurrentSince Jun 21, 2018 Accepting new patients
Institute for Male Health&Performance LLC Family Medicine Past Accepting new patients

Locations

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

13320 N Boulevard St
Vicksburg, MI 49097
Phone (269) 649-2012

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1043334832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16708 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494246043",
            "telephone_number": "616-550-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEAMER AVE",
            "city": "JBER",
            "state": "AK",
            "postal_code": "99506",
            "telephone_number": "907-580-8303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16708 James St",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494246043",
            "country_code": "US",
            "telephone_number": "616-786-0011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16708 James St",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494246043",
            "country_code": "US",
            "telephone_number": "616-786-0011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13320 N Blvd",
            "address_purpose": "LOCATION",
            "city": "Vicksburg",
            "state": "MI",
            "postal_code": "490971514",
            "country_code": "US",
            "telephone_number": "269-649-2012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "SUZANNE",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101010048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jber, AK

Sources for this page

Verify at the official NPI Registry.