Individual provider Active NPI

Jonathan L Hawes, PA

  • Medical Physician Assistant
  • Waukon, IA
National Provider Identifier
1720083363
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
710 Issued in IA
Practice address
40 1St St SE
Waukon, IA 52172-2022
Phone
(563) 568-3411
Fax
(563) 568-6139
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 5

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
710IAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware County Memorial Hospital CurrentSince Oct 4, 2013 Accepting new patients
Veterans Memorial Hospital City of Waukon Ia CurrentSince Jan 1, 2015 Accepting new patients
Palmer Lutheran Health Center, Inc. CurrentSince Sep 1, 2015 Accepting new patients
Delaware County Memorial Hospital CurrentSince Oct 4, 2013 Accepting new patients
Gundersen Clinic LTD Past Accepting new patients

Locations

709 W Main St
Manchester, IA 52057
Phone (563) 927-3232

40 1st St SE
Waukon, IA 52172
Phone (563) 568-3411

110 Jefferson St
West Union, IA 52175
Phone (319) 422-3817

112 Jefferson St
West Union, IA 52175
Phone (563) 422-3811

Interoperability endpoints

  • Direct secure messaging: jhawes79543@direct.gundersenhealth.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 710 IA Primary

Addresses

NPPES NPI Registry

Primary practice location

40 1St St SE
Waukon, IA 52172-2022

Mailing address

40 1St St SE
Waukon, IA 52172-2022
Phone (563) 568-3411

Other practice location 1

110 Jefferson St
West Union, IA 52175-1022
Phone (563) 422-3817

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1720083363MedicaidIA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 22, 2020.

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1720083363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 1ST ST SE",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "521722022",
            "telephone_number": "563-568-3411",
            "fax_number": "563-568-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 1ST ST SE",
            "city": "WAUKON",
            "state": "IA",
            "postal_code": "521722022",
            "telephone_number": "563-568-3411",
            "fax_number": "563-568-6139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Jefferson St",
            "address_purpose": "LOCATION",
            "city": "West Union",
            "state": "IA",
            "postal_code": "521751022",
            "country_code": "US",
            "telephone_number": "563-422-3817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAWES",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720083363",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukon, IA

Sources for this page

Verify at the official NPI Registry.