Individual provider Active NPI

Timothy J. Hawk, RPT

  • Physical Therapist
  • Rogersville, TN
National Provider Identifier
1053307751
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0000001848 Issued in TN
Practice address
482 Park Blvd
Suite 2
Rogersville, TN 37857-6927
Phone
(423) 921-8088
Fax
(423) 921-0046
NPI assigned
Sep 27, 2005
Reactivated
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT0000001848 TN Primary

Addresses

Primary practice location

482 Park Blvd
Suite 2
Rogersville, TN 37857-6927

Mailing address

482 Park Blvd
Suite 2
Rogersville, TN 37857-6927
Phone (423) 921-8088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060907000437 TN Practitioner - Physical Therapist in Private Practice 8729082623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Tennessee, HSC, College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee Physical Therapy, Inc 3 clinicians

Practice addresses (Care Compare)

482 Park Blvd
Rogersville, TN 37857-6927
Phone (423) 921-8088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT0000001848TNMDPhysical Therapist
1848TNMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Physical Therapy, Inc CurrentSince Dec 27, 2024 Accepting new patients
Cherokee Orthotics & Medical Equipment Inc Past Accepting new patients

Locations

482 Park Blvd
Ste 2
Rogersville, TN 37857
Phone (423) 921-8087

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": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1053307751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 PARK BLVD",
            "address_2": "SUITE 2",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378576927",
            "telephone_number": "423-921-8088",
            "fax_number": "423-921-0046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 PARK BLVD",
            "address_2": "SUITE 2",
            "city": "ROGERSVILLE",
            "state": "TN",
            "postal_code": "378576927",
            "telephone_number": "423-921-8088",
            "fax_number": "423-921-0046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWK",
        "first_name": "TIMOTHY",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "deactivation_date": "2006-03-25",
        "reactivation_date": "2006-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000001848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogersville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.