John William Hathaway Jr., FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95035568 Issued in CA

Practice address

31571 Canyon Estates Dr Ste 228
Lake Elsinore, CA 92532-0425

Phone

(951) 471-0200

NPI assigned

Jun 13, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shadi a. Qasqas MD, Inc.

  • Cardiovascular Disease Physician
  • Upland, CA
  • NPI 1891929287
  NPD (past)

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1497641732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 BRACEBRIDGE RD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925066114",
            "telephone_number": "951-454-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31571 CANYON ESTATES DR STE 228",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320425",
            "telephone_number": "951-471-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4646 Brockton Ave Ste 202-4",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925060172",
            "country_code": "US",
            "telephone_number": "951-471-0200",
            "fax_number": "951-240-3715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-13",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95035568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Harrigan
• Paula F Harrison, IMF
• Jack Hartwell, DPT
• Marinna Ashlee Hartwick
• Derrick B Harvey
• Hauser Phillipe Dental Partnership
• Derek B. Hauser, DDS
• Tracey Denise Hauser, LVN
• Brian Eugene Hawkins
• Madison Hendrix, RADT

• Family Nurse Practitioner in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.