Individual provider Active NPI

Joe Nathan Hackworth, M.D.

  • Cardiovascular Disease Physician
  • Cincinnati, OH
National Provider Identifier
1619974987
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
33001 Issued in KY
Practice address
4101 Edwards Rd
Second Floor
Cincinnati, OH 45209-1672
Phone
(513) 985-0741
Fax
(513) 979-2830
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35-03-9624 OH
Interventional Cardiology Physician 207RI0011X 35039624 OH
Cardiovascular Disease Physician 207RC0000X 33001 KY Primary

Addresses

Primary practice location

4101 Edwards Rd
Second Floor
Cincinnati, OH 45209-1672

Mailing address

4101 Edwards Rd
Second Floor
Cincinnati, OH 45209-1672
Phone (513) 985-0741

Other practice location 1

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-7751

Other practice location 2

1320 W Main St
Newark, OH 43055-1822
Phone (220) 564-7751

Other identifiers 8

IdentifierTypeStateIssuer
0369006OtherKYMEDICARE
060037112OtherRR MEDICARE
P00884967OtherOHRR MEDICARE
0562606OtherKYMEDICARE
64739444MedicaidKY
611300608052OtherOHCARESOURCE
0317857MedicaidOH
0369106OtherKYMEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jhackworth14518@lickingmemorial.medicity.net Other LICKING MEMORIAL PROFESSIONAL CORPORATION
Direct Messaging Address jhackworth14518@lickingmemorial.medicity.net Other LICKING MEMORIAL PROFESSIONAL CORPORATION

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040504000201 OH Practitioner - Cardiovascular Disease (Cardiology) 8426945833 Reassigns benefits to 3 organizations
I20070714000027 KY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8426945833 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33001KYMDCardiovascular Disease Physician
35039624OHMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Health Professionals Current Accepting new patients
Mercy Health Physicians Cincinnati LLC CurrentSince Oct 1, 2014 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC Cardiovascular Disease CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians Cincinnati, LLC Cardiovascular Disease CurrentSince Oct 1, 2014 Accepting new patients
Adena Medical Group LLC Interventional Cardiology CurrentSince Dec 26, 2014 Accepting new patients
Summit Medical Group, Inc Past Accepting new patients
Comprehensive Cardiology Cons Inc Cardiovascular Disease Past Accepting new patients
Cardiovascular Partners LLC Cardiovascular Disease Past Accepting new patients
Diagnostic Cardiologists Inc. Cardiovascular Disease Past Accepting new patients

Locations

3955 Alexandria Pike
Cold Spring, KY 41076
Phone (859) 431-4430

4437 State Route 159
Ste 125
Chillicothe, OH 45601
Phone (740) 779-4570

1701 Mercy Health Pl
Ofc
Cincinnati, OH 45237

4101 Edwards Rd
Fl 2
Cincinnati, OH 45209
Phone (513) 981-4646

2446 Kipling Ave
Cincinnati, OH 45239
Phone (513) 583-8500

4777 E Galbraith Rd
Cincinnati, OH 45236
Phone (513) 686-3000

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

2960 Mack Rd
Ste 206
Hamilton, OH 45014
Phone (513) 860-4722

9313 S Mason Montgomery Rd
Ste 250
Mason, OH 45040
Phone (513) 584-6898

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1619974987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 EDWARDS RD",
            "address_2": "SECOND FLOOR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091672",
            "telephone_number": "513-985-0741",
            "fax_number": "513-979-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 EDWARDS RD",
            "address_2": "SECOND FLOOR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452091672",
            "telephone_number": "513-985-0741",
            "fax_number": "513-979-2830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 W Main St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551822",
            "country_code": "US",
            "telephone_number": "220-564-7751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 W Main St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "OH",
            "postal_code": "430551822",
            "country_code": "US",
            "telephone_number": "220-564-7751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HACKWORTH",
        "first_name": "JOE",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35-03-9624",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35039624",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "33001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0369006",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060037112",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00884967",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0562606",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64739444",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "611300608052",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0317857",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0369106",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhackworth14518@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhackworth14518@lickingmemorial.medicity.net",
            "affiliation": "Y",
            "endpointDescription": "DIRECT EMAIL ADDRESS",
            "affiliationName": "LICKING MEMORIAL PROFESSIONAL CORPORATION",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "1320 W Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430551822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.