NPIMap

Individual provider Active NPI

Kenneth W. Hawk, NP

  • Family Nurse Practitioner
  • Oakland, MD
National Provider Identifier
1427047240
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R167958 Issued in MD
Practice address
311 N 4TH St
Oakland, MD 21550-1371
Phone
(301) 334-7420
Fax
(301) 334-1819
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 57454 WV
Family Nurse Practitioner 363LF0000X R167958 MD Primary

Addresses

Primary practice location

311 N 4TH St
Oakland, MD 21550-1371

Mailing address

311 N 4TH St
Oakland, MD 21550-1371
Phone (301) 334-7420

Other identifiers 1

IdentifierTypeStateIssuer
3810001587MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050928000387 MD Practitioner - Nurse Practitioner 1850341421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

311 N 4TH St
Oakland, MD 21550-1371
Phone (301) 334-8171

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R167958MDMDFamily Nurse Practitioner
57454WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Physicians of Garrett County, LLC Current Accepting new patients
Specialty Physicians of Garrett County, LLC CurrentSince Jan 1, 2024 Accepting new patients
Specialty Physicians of Garrett County, LLC CurrentSince Jan 1, 2024 Accepting new patients
Professional Emergency Physician Services, LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

311 N 4th St
Oakland, MD 21550
Phone (301) 334-7420

880 Memorial Dr
Lowr Level
Oakland, MD 21550
Phone (301) 334-1177

251 N 4th St
Oakland, MD 21550
Phone (301) 533-4000

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.

Hospital & facility affiliations 4

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1427047240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N 4TH ST",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501371",
            "telephone_number": "301-334-7420",
            "fax_number": "301-334-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N 4TH ST",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501371",
            "telephone_number": "301-334-7420",
            "fax_number": "301-334-1819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWK",
        "first_name": "KENNETH",
        "middle_name": "W.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "57454",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R167958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001587",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

Verify at the official NPI Registry.