Individual provider Active NPI

Kathy Marie Hawkins

  • Family Nurse Practitioner
  • Braselton, GA
National Provider Identifier
1750774592
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN 179243 Issued in GA
Practice address
2404 Fisk Falls Dr
Braselton, GA 30517-3413
Phone
(770) 570-0845
NPI assigned
Mar 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 179243 GA
Family Nurse Practitioner 363LF0000X RN 179243 GA Primary

Addresses

Primary practice location

2404 Fisk Falls Dr
Braselton, GA 30517-3413

Mailing address

2404 Fisk Falls Dr
Braselton, GA 30517-3413
Phone (770) 570-0845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160225000430 GA Practitioner - Nurse Practitioner 1355646589 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
179243GAMDNurse Practitioner
RN 179243GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Jan 8, 2016 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Jan 8, 2016 Accepting new patients
Kaleem Ahmed MD PC Past Accepting new patients
Grady Memorial Hospital Corporation Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

80 Jesse Hill Jr Dr SE
#88
Atlanta, GA 30303
Phone (404) 616-0879

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426550400000",
    "number": "1750774592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 FISK FALLS DR",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305173413",
            "telephone_number": "770-570-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 FISK FALLS DR",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305173413",
            "telephone_number": "770-570-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "KATHY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "179243",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN 179243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Braselton, GA

Sources for this page

Verify at the official NPI Registry.