Individual provider Active NPI

Stephanie K. Hawley, M.D.

  • Emergency Medicine Physician
  • Carbondale, IL
National Provider Identifier
1245523091
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.141607 Issued in IL
Practice address
405 W Jackson St
Carbondale, IL 62901-1462
Phone
(618) 549-0721
Fax
(618) 457-0469
NPI assigned
May 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2014-00367 NC
Emergency Medicine Physician 207P00000X 01077936A IN
Student in an Organized Health Care Education/Training Program 390200000X C7-0004772 DE
Emergency Medicine Physician 207P00000X 036.141607 IL Primary

Addresses

Primary practice location

405 W Jackson St
Carbondale, IL 62901-1462

Mailing address

105 Longleaf LN
New Bern, NC 28562-3675
Phone (618) 549-0721

Other practice location 1

201 S 14th St
Herrin, IL 62948-3631
Phone (618) 942-2171

Other practice location 2

2 S Hospital Dr
Murphysboro, IL 62966-3333
Phone (618) 684-3156

Other practice location 3

1606 N 7th St
Terre Haute, IN 47804-2706
Phone (252) 633-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, OH, DE3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20141111000688 NC Practitioner - Emergency Medicine 9830322932 Reassigns benefits to 2 organizations
I20161205001641 OH Practitioner - Emergency Medicine 9830322932
I20180517002769 DE Practitioner - Emergency Medicine 9830322932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.98 of 100Reported as group
Quality
78.42
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.141607ILMDEmergency Medicine Physician
2014-00367NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group Affiliates LLC CurrentSince Dec 15, 2016 Accepting new patients
Vidant Medical Group LLC CurrentSince Oct 1, 2016 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Nov 1, 2015 Accepting new patients
Bayhealth Emergency Physicians LLC Emergency Medicine CurrentSince Apr 10, 2018 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

18383 Hudson Rd
Ste A
Milton, DE 19968
Phone (302) 725-3500

2310 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 847-6611

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

4800 S Croatan Hwy
Nags Head, NC 27959
Phone (252) 449-4500

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

Organizations & group practices 5

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": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245523091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 LONGLEAF LN",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285623675",
            "telephone_number": "618-549-0721",
            "fax_number": "618-457-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721",
            "fax_number": "618-457-0469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 S 14th St",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483631",
            "country_code": "US",
            "telephone_number": "618-942-2171",
            "fax_number": "618-529-0524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 S Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663333",
            "country_code": "US",
            "telephone_number": "618-684-3156",
            "fax_number": "618-529-0524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1606 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Terre Haute",
            "state": "IN",
            "postal_code": "478042706",
            "country_code": "US",
            "telephone_number": "252-633-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWLEY",
        "first_name": "STEPHANIE",
        "middle_name": "K.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2014-00367",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01077936A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DE",
            "license": "C7-0004772",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.141607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.