Jack Hawks, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4049 Issued in AZ

Practice address

9191 W. Thunderbird Rd.
Suite D-105
Peoria, AZ 85381-4816

Phone

(623) 849-3811

Fax

(623) 849-5221

NPI assigned

Aug 30, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Ceb Capital LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1750754982
  Medicare reassignment NPD
• Jack Hawks PC

  • Specialist
  • Peoria, AZ
  • NPI 1972626141
  Authorized official Same address or phone
• Ceb Capital LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1073986212
  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194835660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 W. THUNDERBIRD RD.",
            "address_2": "SUITE D-105",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814816",
            "telephone_number": "623-849-3811",
            "fax_number": "623-849-5221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 W. THUNDERBIRD RD.",
            "address_2": "SUITE D-105",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814816",
            "telephone_number": "623-849-3811",
            "fax_number": "623-849-5221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKS",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "4049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "950982",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mikayla Rae Haukenfrers, MOT/R
• Jeremy Hauptman, OD
• Haven Eeoi Holdings LLC (Haven Specialty Home Care)
• Haven One-Eighty LLC (Haven One-Eighty)
• Kasey Hawkinson, LAC
• Mary Haynes, M.S., OTR/L
• HDP Fox Dental LLC (Fox Family Dental)
• Healing Touch Family Chiropractic, P.C. (Healing Touch Family Chiropractic)
• Healingfx LLC
• Health and Safety Consultants, LLC

• Family Medicine Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.