Individual provider Active NPI

Peter W. Hawkins, PA-C

  • Physician Assistant
  • Roxboro, NC
National Provider Identifier
1255755740
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04686 Issued in NC
Practice address
3762 Durham Rd Ste a
Roxboro, NC 27573-2741
Phone
(336) 330-0400
Fax
(336) 330-0031
NPI assigned
Feb 5, 2014
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04686 NC Primary

Addresses

Primary practice location

3762 Durham Rd Ste a
Roxboro, NC 27573-2741

Mailing address

3762 Durham Rd Ste a
Roxboro, NC 27573-2741
Phone (336) 330-0400

Other practice location 1

1614 Nc Highway 56
Creedmoor, NC 27522-8297
Phone (919) 575-6103

Other identifiers 1

IdentifierTypeStateIssuer
1255755740MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20140418000457 NC Practitioner - Physician Assistant 2264664580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granville Health SystemGroup PAC ID 1052223757, 78 clinicians

Practice addresses (Care Compare)

1614 NC Hwy 56
Creedmoor, NC 27522-8297
Phone (919) 575-6103

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Granville Health System CurrentSince Apr 17, 2023 Accepting new patients
Granville Health System CurrentSince Apr 17, 2023 Accepting new patients
DLP Person Urgent Care LLC CurrentSince Sep 15, 2018 Accepting new patients
DLP Person Urgent Care LLC CurrentSince Sep 15, 2018 Accepting new patients

Locations

1840 Martin Luther King Jr Blvd
Ste C4
Chapel Hill, NC 27514
Phone (919) 510-6679

1614 NC Highway 56
Creedmoor, NC 27522
Phone (919) 528-7171

3762 Durham Rd
Roxboro, NC 27573
Phone (336) 330-0400

3762 Durham Rd
Ste A
Roxboro, NC 27573
Phone (336) 330-0400

Interoperability endpoints

  • Direct secure messaging: peterhawkins@gvhs.allscriptsdirect.net

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, 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": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1255755740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3762 DURHAM RD STE A",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275732741",
            "telephone_number": "336-330-0400",
            "fax_number": "336-330-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3762 DURHAM RD STE A",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275732741",
            "telephone_number": "336-330-0400",
            "fax_number": "336-330-0031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1614 Nc Highway 56",
            "address_purpose": "LOCATION",
            "city": "Creedmoor",
            "state": "NC",
            "postal_code": "275228297",
            "country_code": "US",
            "telephone_number": "919-575-6103",
            "fax_number": "919-575-6817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "PETER",
        "middle_name": "W.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-05",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255755740",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxboro, NC

Sources for this page

Verify at the official NPI Registry.