Individual provider Active NPI

Terresa Louise Hawthorne, MD

  • Family Medicine Physician
  • Columbus, OH
National Provider Identifier
1104891944
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3504789OH Issued in OH
Practice address
1160 W Broad St
Columbus, OH 43222-1352
Phone
(614) 274-1455
Fax
(614) 274-1433
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 35047890 OH
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 35047890 OH
General Practice Physician 208D00000X 35047890 OH
Family Medicine Physician 207Q00000X 3504789OH OH Primary

Addresses

Primary practice location

1160 W Broad St
Columbus, OH 43222-1352

Mailing address

1155 E Main St
Lancaster, OH 43130-4056
Phone (740) 277-6237

Other identifiers 1

IdentifierTypeStateIssuer
0892584MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040618001132 OH Practitioner - Family Practice 7113902701 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3504789OHOHMDFamily Medicine Physician
35047890OHMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Lights Christian Health Center, Inc Current Accepting new patients
Lower Lights Christian Health Center, Inc. Current Accepting new patients
Lower Lights Christian Health Center Inc CurrentSince Nov 4, 2017 Accepting new patients
Lower Lights Christian Health Center Inc Current Accepting new patients
Lower Lights Christian Health Center, Inc. Current Accepting new patients
Lower Lights Christian Health Center, Inc CurrentSince Nov 4, 2017 Accepting new patients
Lower Lights Christian Health Center, Inc Current Accepting new patients
Lower Lights Christian Health Center Inc Current Accepting new patients
Ross County Health District Past Accepting new patients
Medical Service Associates of Xenia Inc Family Medicine Past Accepting new patients

Locations

L3957
Columbus, OH 43260

1160 W Broad St
Columbus, OH 43222
Phone (614) 947-7615

777 W State St
Ste 201
Columbus, OH 43222
Phone 6142741455313

1560 S High St
Columbus, OH 43207
Phone 61427414556220

773 S Walnut St
Marysville, OH 43040
Phone (937) 578-2860

6000 Cooper Rd
Westerville, OH 43081
Phone (614) 259-5361

Organizations & group practices 10

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1104891944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 E MAIN ST",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431304056",
            "telephone_number": "740-277-6237",
            "fax_number": "740-689-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221352",
            "telephone_number": "614-274-1455",
            "fax_number": "614-274-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWTHORNE",
        "first_name": "TERRESA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35047890",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "OH",
            "license": "35047890",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35047890",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "3504789OH",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0892584",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.