Active NPI
Jonathan L Hawes, PA
- Medical Physician Assistant
- Waukon, IA
National Provider Identifier
1720083363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 710
- 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.
-
- Rural Health Clinic/Center
- Manchester, IA
- NPI 1528209483
-
- Rural Health Clinic/Center
- Dyersville, IA
- NPI 1689264756
-
- Critical Access Hospital
- West Union, IA
- NPI 1891744108
-
- Rural Health Clinic/Center
- Postville, IA
- NPI 1417696527
-
- Clinic/Center
- La Crosse, WI
- NPI 1851343115
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 710 | IA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware County Memorial Hospital | Current | Accepting new patients | |
| Veterans Memorial Hospital City of Waukon Ia | Current | Accepting new patients | |
| Palmer Lutheran Health Center, Inc. | Current | Accepting new patients | |
| Delaware County Memorial Hospital | Current | 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
- jhawes79543@direct.gundersenhealth.org
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 710 | IA | Primary |
Addresses
NPPES NPI RegistryPrimary 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| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720083363 | Medicaid | IA |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.