Michael Calvin Hawthorne, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

P1367 Issued in TN

Practice address

1111 N Northshore Dr
Suite South 490
Knoxville, TN 37919-4005

Phone

(865) 584-0171

Fax

(865) 584-0171

NPI assigned

Jul 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Northshore Group IncGroup PAC ID 7012374929, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• The Northshore Group, Inc.

  • Clinical Psychologist
  • Knoxville, TN
  • NPI 1790423366
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063427821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N NORTHSHORE DR",
            "address_2": "SUITE SOUTH 490",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194005",
            "telephone_number": "865-584-0171",
            "fax_number": "865-584-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N NORTHSHORE DR",
            "address_2": "SUITE SOUTH 490",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194005",
            "telephone_number": "865-584-0171",
            "fax_number": "865-584-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWTHORNE",
        "first_name": "MICHAEL",
        "middle_name": "CALVIN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P1367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2005673",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Leigh Hawn, NP
• Thomas Francis Haws, DDS
• Hawthorn Midwifery LLC
• Christa Hawthorne-Nardini, LPTA
• Kathryn Hawthorne
• Heather Harris Hay, AUD
• Mackenzie David Hay, M.D.
• John Michael Haydek, MD
• Jason L Hayden, CP
• Jaema Hayes

• Clinical Psychologist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Clinical Psychologist in Tennessee

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.