Individual provider Active NPI

Craig D Hawkins, PT

  • Physical Therapist
  • Keizer, OR
National Provider Identifier
1295786127
Registry record updated Jan 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4634 Issued in OR
Practice address
4025 Cherry Ave NE
Keizer, OR 97303-4859
Phone
(503) 390-9009
Fax
(503) 304-2226
NPI assigned
May 15, 2006
Last updated
Jan 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4634 OR Primary

Addresses

Primary practice location

4025 Cherry Ave NE
Keizer, OR 97303-4859

Mailing address

4025 Cherry Ave NE
Keizer, OR 97303-4859
Phone (503) 390-9009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070910000279 OR Practitioner - Physical Therapist in Private Practice 6103919014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Rehabilitation Associates IncGroup PAC ID 5991753592, 32 clinicians

Practice addresses (Care Compare)

4025 Cherry Ave NE
Keizer, OR 97303-4859
Phone (503) 390-9009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4634ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Rehabilitation Associates, Inc. Physical Therapist CurrentSince Mar 4, 2022 Accepting new patients
Pinnacle Physical Therapy LLC. Past Accepting new patients

Locations

210 W Ellendale Ave
Ste 100
Dallas, OR 97338
Phone (503) 623-2433

4025 Cherry Ave NE
Keizer, OR 97303
Phone (503) 390-9009

3270 Liberty Rd S
Salem, OR 97302
Phone (503) 371-0779

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546732800000",
    "number": "1295786127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 CHERRY AVE NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034859",
            "telephone_number": "503-390-9009",
            "fax_number": "503-304-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 CHERRY AVE NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034859",
            "telephone_number": "503-390-9009",
            "fax_number": "503-304-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "CRAIG",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2019-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "4634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2019; 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.