Individual provider Active NPI

Yashica Nakiya Hawkins, ANP

  • Adult Health Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1104161405
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2012022147 Issued in MO
Practice address
8229 Clayton Rd Ste 202
Saint Louis, MO 63117-1155
Phone
(314) 473-5661
NPI assigned
Nov 28, 2012
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2012022147 MO
Adult Health Nurse Practitioner 363LA2200X ARNP9454295 FL
Adult Health Nurse Practitioner 363LA2200X 77949 KS
Adult Health Nurse Practitioner 363LA2200X 2012022147 MO Primary

Addresses

Primary practice location

8229 Clayton Rd Ste 202
Saint Louis, MO 63117-1155

Mailing address

8229 Clayton Rd Ste 202
Saint Louis, MO 63117-1155
Phone (314) 473-5661

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20130213000064 MO Practitioner - Nurse Practitioner 1153575550 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9454295FLMDAdult Health Nurse Practitioner
77949KSMDAdult Health Nurse Practitioner
2012022147MOMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC CurrentSince Dec 8, 2023 Accepting new patients
Vpa PC CurrentSince Dec 8, 2023 Accepting new patients

Locations

8706 Manchester Rd
Ste 106
Saint Louis, MO 63144
Phone (314) 961-3570

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1104161405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8229 CLAYTON RD STE 202",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171155",
            "telephone_number": "314-473-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8229 CLAYTON RD STE 202",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171155",
            "telephone_number": "314-473-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "YASHICA",
        "middle_name": "NAKIYA",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-28",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2012022147",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9454295",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KS",
            "license": "77949",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2012022147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.