Individual provider Active NPI

Sally Ann Hawkins, ARNP FNP-BC

  • Family Nurse Practitioner
  • Klamath Falls, OR
National Provider Identifier
1427619329
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10033241 Issued in OR
Practice address
3737 Shasta Way
Klamath Falls, OR 97603-4884
Phone
(541) 883-2337
Fax
(541) 883-2504
NPI assigned
Jun 22, 2019
Last updated
Jun 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10033241 OR Primary

Addresses

Primary practice location

3737 Shasta Way
Klamath Falls, OR 97603-4884

Mailing address

705 Dolly Ben CT
Winter Haven, FL 33880-5735
Phone (863) 258-2870

Other names 1

  • Sally Hawkins Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240710001078 RI Practitioner - Nurse Practitioner 8224460845 Reassigns benefits to 1 organization
I20250707001567 OR Practitioner - Nurse Practitioner 8224460845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

3737 Shasta Way
Suite a
Klamath Falls, OR 97603-4982
Phone (541) 640-7625

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC CurrentSince May 27, 2025 Accepting new patients
Icco LLC CurrentSince May 27, 2025 Accepting new patients
Concertocare Medical Group of Rhode Island, PC CurrentSince May 5, 2024 Accepting new patients
Icco, LLC Family Medicine Past Accepting new patients

Locations

600 Jefferson St
Ste 600
Lafayette, LA 70501
Phone (337) 202-0720

811 Main St
#7
Kansas City, MO 64105

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611

1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

10 Dorrance St
Ste 700
Providence, RI 02903
Phone (401) 200-8242

Organizations & group practices 4

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 2

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": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1427619329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 DOLLY BEN CT",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338805735",
            "telephone_number": "863-258-2870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SHASTA WAY",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034884",
            "telephone_number": "541-883-2337",
            "fax_number": "541-883-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "credential": "ARNP FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10033241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "HAWKINS",
            "credential": "FNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.