Individual provider Active NPI

Tracie Hawkins, MSN, APN, FNP-C

  • Family Nurse Practitioner
  • Mount Laurel, NJ
National Provider Identifier
1124894019
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ14965200 Issued in NJ
Practice address
3906 Church Rd
Mount Laurel, NJ 08054-1108
Phone
(856) 266-5260
NPI assigned
Nov 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ14965200 NJ Primary

Addresses

Primary practice location

3906 Church Rd
Mount Laurel, NJ 08054-1108

Mailing address

24 Crows Nest CT
Mount Laurel, NJ 08054-6109
Phone (856) 816-3830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240209000434 NJ Practitioner - Nurse Practitioner 2062855729 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Healthcare and Hospice Inc 22 clinicians

Practice addresses (Care Compare)

3906 Church Rd
Mount Laurel, NJ 08054-1108
Phone (856) 552-3261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Homevisit Physicians PC CurrentSince Nov 1, 2024 Accepting new patients
Samaritan Healthcare & Hospice, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Personal NP Services, LLC CurrentSince Feb 1, 2024 Accepting new patients

Locations

685 River Ave
Unit 3
Lakewood, NJ 08701
Phone (732) 987-3855

456 Chestnut St
Ste 102
Lakewood, NJ 08701
Phone (732) 282-7200

3906 Church Rd
#P
Mount Laurel, NJ 08054
Phone (856) 552-3261

3906 Church Rd
Ste 300
Mount Laurel, NJ 08054

3906 Church Rd
Mount Laurel, NJ 08054
Phone (856) 222-3292

3906 Church Rd
Ste 200
Mount Laurel, NJ 08054

3906 Church Rd
Ste 100
Mount Laurel, NJ 08054

Organizations & group practices 4

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": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1124894019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CROWS NEST CT",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080546109",
            "telephone_number": "856-816-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3906 CHURCH RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541108",
            "telephone_number": "856-266-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "TRACIE",
        "credential": "MSN, APN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14965200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.