Individual provider Active NPI

Jonathan Hajduk, DO

  • Student in an Organized Health Care Education/Training Program
  • Newport News, VA
National Provider Identifier
1073197885
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0116041965 Issued in VA
Practice address
500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone
(757) 612-7200
NPI assigned
May 7, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116041965 VA Primary
General Practice Physician 208D00000X DO87837 SC

Addresses

Primary practice location

500 J Clyde Morris Blvd
Newport News, VA 23601-1929

Mailing address

Opc 41 Box 15
Apo, AE 09461

Other practice location 1

Opc 41 Box 15
Apo, AE 09461
Phone (314) 226-9050

Other practice location 2

128 E Apple St
Dayton, OH 45409-2902
Phone (937) 208-2951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO87837SCMDGeneral Practice Physician
0116041965VAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1073197885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "OPC 41 BOX 15",
            "city": "APO",
            "state": "AE",
            "postal_code": "09461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-612-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "OPC 41 BOX 15",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AE",
            "postal_code": "09461",
            "country_code": "US",
            "telephone_number": "314-226-9050",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "128 E Apple St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092902",
            "country_code": "US",
            "telephone_number": "937-208-2951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAJDUK",
        "first_name": "JONATHAN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-07",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116041965",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "SC",
            "license": "DO87837",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.