Betty Jean Hathaway

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

1290 Tavern Rd
Mammoth Lakes, CA 93546-6601

Phone

(760) 924-1740

NPI assigned

Dec 18, 2018

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• County of Mono

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mammoth Lakes, CA
  • NPI 1538266911
  NPD
• Mono County Behavioral Health

  • Community/Behavioral Health Agency
  • Mammoth Lakes, CA
  • NPI 1861050643
  NPD

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1669944492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 SANDSTONE DR",
            "city": "WELLINGTON",
            "state": "NV",
            "postal_code": "894449437",
            "telephone_number": "775-781-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 TAVERN RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935466601",
            "telephone_number": "760-924-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "BETTY",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Georgeson, PHYSICAL THERAPIST
• Jordan Gray, D.C.
• Amanda Fenn Greenberg
• Richard Edward Hamilton Jr., M.D.
• Renee Elizabeth Hartsman, FNP
• Mary Elizabeth Heller, R.N.,M.S.,C.F.N.P.
• Constance M. Henderson, L.C.S.W.
• Shane Hennes
• Kyle Howell, M.D.
• Christopher Hummel, M.D.

• Community Health Worker in Mammoth Lakes, CA
• Providers in Mammoth Lakes, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.