Active NPI
Danielle Hawthorne
- Diagnostic Radiology Physician
- Springfield, IL
National Provider Identifier
1043901622
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 125081495
- Practice address
- 800 E Carpenter St Box 43
Springfield, IL 62769-4968 - Phone
- (217) 814-5187
- Fax
- (217) 757-6458
- NPI assigned
- May 16, 2023
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 125081495 | IL | Primary |
Addresses
Primary practice location
800 E Carpenter St Box 43
Springfield, IL 62769-4968
Mailing address
800 E Carpenter St Box 43
Springfield, IL 62769-0001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230727000418 | IL | Order and Referring Only - Diagnostic Radiology | 9436510294 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125081495 | IL | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723593600000",
"number": "1043901622",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 E CARPENTER ST BOX 43",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627690001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E CARPENTER ST BOX 43",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627694968",
"telephone_number": "217-814-5187",
"fax_number": "217-757-6458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWTHORNE",
"first_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-16",
"last_updated": "2024-08-14",
"certification_date": "2024-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "125081495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.