Individual provider Active NPI

Jeffrey Hackworth, DO

  • Internal Medicine Physician
  • Kirksville, MO
National Provider Identifier
1235624354
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T8554 Issued in TX
Practice address
315 S Osteopathy Ave
Kirksville, MO 63501-6401
Phone
(660) 785-1000
NPI assigned
Jun 30, 2018
Last updated
Feb 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2018022479 MO
Internal Medicine Physician 207R00000X T8554 TX Primary
General Practice Physician 208D00000X 2019036773 MO

Addresses

Primary practice location

315 S Osteopathy Ave
Kirksville, MO 63501-6401

Mailing address

602 W Link St
Kirksville, MO 63501-4342
Phone (909) 374-7466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220914001847 TX Practitioner - Internal MedicinePractitioner - General Practice 5597159699 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Touro Un College of Osteopathic Medicine, Vallejo, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

8200 Walnut Hill LN
Presbyterian Hospital Dallas
Dallas, TX 75231-4426
Phone (214) 345-6789

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018022479MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Urgent Care LLC CurrentSince May 1, 2024 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Family Medicine CurrentSince Jul 11, 2022 Accepting new patients
Flow Health PC Family Medicine CurrentSince Jan 6, 2026 Accepting new patients
Post Oak Urgent Care PLLC Family Medicine CurrentSince May 1, 2024 Accepting new patients
Cogent Healthcare of Texas, PA Family Medicine CurrentSince Jul 11, 2022 Accepting new patients
Mochi Medical Ca PC Past Accepting new patients

Locations

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

800 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 548-6100

811 Wright St
Arlington, TX 76012
Phone (817) 960-3500

1903 Central Dr
Ste 215
Bedford, TX 76021
Phone (817) 508-0447

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

8101 Boat Club Rd
Ste 318
Fort Worth, TX 76179
Phone (407) 315-2271

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

14522 S Post Oak Rd
Ste 203B
Houston, TX 77045
Phone (713) 434-9270

8300 Antoine Dr
Ste D
Houston, TX 77088
Phone (281) 925-7547

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

3150 Horizon Rd
Rockwall, TX 75032
Phone (469) 697-1000

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1530316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1235624354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 W LINK ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014342",
            "telephone_number": "909-374-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S OSTEOPATHY AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635016401",
            "telephone_number": "660-785-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKWORTH",
        "first_name": "JEFFREY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-30",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2018022479",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T8554",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2019036773",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirksville, MO

Sources for this page

Verify at the official NPI Registry.