Nickoline M Hathaway, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G47705 Issued in CA

Practice address

152 Pioneer LN
Suite C
Bishop, CA 93514-2563

Phone

(760) 873-7111

NPI assigned

Jun 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Internal Medicine

Education

Un of California, Irvine, College of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Inyo Healthcare DistrictGroup PAC ID 8921992090, 104 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Inyo Hospital Hospital, Bishop, CA, CCN 051324

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Northern Inyo Healthcare District

  • Critical Access Hospital
  • Bishop, CA
  • NPI 1922198712
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northern Inyo Healthcare District

  • Critical Access Hospital
  • Bishop, CA
  • NPI 1922198712
  Care Compare affiliation

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629005749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 PIONEER LN",
            "address_2": "SUITE C",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142563",
            "telephone_number": "760-873-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 PIONEER LN",
            "address_2": "SUITE C",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "935142563",
            "telephone_number": "760-873-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "NICKOLINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G47705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G477050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne M Goshgarian, MD
• David Lee Greene, MD
• Greenfield Country Club
• Catherine Grisham, CADC-CAS
• Donald Eugene Harjo, CNA, PHLEBOTOMIST
• Elizabeth Elaine Haun, FNP
• John Adam Hawkins
• Katie Dawn Hawkins, MSW, LCSW
• Michael D. Heinlein, LCSW
• Helping Hands 4 Housing, Inc

• Internal Medicine Physician in Bishop, CA
• Providers in Bishop, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.