Jillisa D Hawk, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5652P Issued in KY

Practice address

305 Estill St
Berea, KY 40403-1742

Phone

(859) 986-9521

Fax

(859) 986-7369

NPI assigned

Aug 15, 2008

Last updated

Aug 15, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21269/brand/3/csg/1/fhir/r4

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.

• Lake Cumberland Regional Hospital LLC

  • Internal Medicine Physician
  • Somerset, KY
  • NPI 1861078685

  Family

  Medicare reassignment NPD
• Nautilus Health Care Group, PLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Somerset, KY
  • NPI 1164866877
  Medicare reassignment NPD
• Lake Cumberland Regional Hospital LLC

  dba Lake Cumberland Medical Associates

  • Rural Health Clinic/Center
  • Somerset, KY
  • NPI 1023155462
  NPD
• Lake Cumberland Regional Hospital, LLC

  • Internal Medicine Physician
  • Somerset, KY
  • NPI 1447330451

  Family

  NPD
• Strauss Family Practice, LLC

  • Rural Health Clinic/Center
  • Richmond, KY
  • NPI 1083656268
  NPD (past)
• Nautilus Health Care Group LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Melbourne, FL
  • NPI 1912013558
  NPD (past)

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1053567552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 484",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404030484",
            "telephone_number": "859-986-9521",
            "fax_number": "859-986-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 ESTILL ST",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031742",
            "telephone_number": "859-986-9521",
            "fax_number": "859-986-7369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWK",
        "first_name": "JILLISA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "5652P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clyde D Harmon Jr.
• Aleshia Ariel Harris, OTR/L
• Hayley Harris
• Mary Abigail Hassert, OTR/L
• Chandre Hatton, APRN
• Charles R Hazle Jr., DPT
• Health Help Inc (Berea White House Clinic Pharmacy)
• Health Help Incorporated (White House Clinic)
• Health Help Incorporated (White House Clinics)
• Health Help Incorporated

• Family Nurse Practitioner in Berea, KY
• Providers in Berea, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.

Verify at the official NPI Registry.