Susanne Peacock Hawthorne, PA - C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-03993 Issued in NC

Practice address

200 Greenwich Rd
Charlotte, NC 28211-2316

Phone

(704) 384-8680

Fax

(704) 384-8684

NPI assigned

Dec 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1710223409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-8680",
            "fax_number": "704-384-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GREENWICH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112316",
            "telephone_number": "704-384-8680",
            "fax_number": "704-384-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWTHORNE",
        "first_name": "SUSANNE",
        "middle_name": "PEACOCK",
        "name_prefix": "Ms.",
        "credential": "PA - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-03993",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Hawks, BCBA
• Parker Hawks, PT, DPT
• Tammy H Hawks, OD
• Je'Coy Cecil Hawley
• Jennifer Bruckman Hawthorne, M.A., PSY.D.
• Tammy L Hay, D.O.
• Hayat LLC
• Adrianna Tamara Hayden, MS
• Breana Hayden
• Gregg Hayden

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.