Individual provider Active NPI

Kelly Hawthorne

  • Geriatric Physical Therapist
  • Cedar Rapids, IA
National Provider Identifier
1144094269
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
03085 Issued in IA
Practice address
701 10TH St SE
Cedar Rapids, IA 52403-1251
Phone
(319) 398-6915
NPI assigned
Nov 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 03085 IA Primary

Addresses

Primary practice location

701 10TH St SE
Cedar Rapids, IA 52403-1251

Mailing address

2456 Bluegrass St
Marion, IA 52302-6004
Phone (773) 531-4547

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231213001446 IA Practitioner - Physical Therapist in Private Practice 3577912732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1715 1St Ave SE
Suite 200
Cedar Rapids, IA 52402-5432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center Current Accepting new patients
Mercy Medical Center CurrentSince Nov 4, 2023 Accepting new patients
Mercy Medical Center CurrentSince Nov 4, 2023 Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

225 Welter Dr
Monticello, IA 52310
Phone (319) 398-6020

Organizations & group practices 3

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": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1144094269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 BLUEGRASS ST",
            "city": "MARION",
            "state": "IA",
            "postal_code": "523026004",
            "telephone_number": "773-531-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031251",
            "telephone_number": "319-398-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWTHORNE",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "IA",
            "license": "03085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.