Jason John Hawkins
Individual provider Active NPI Home Health Aide · Ecorse, MI
NPI 1780060434 · NPPES record last updated Aug 5, 2015
Key facts
- NPI
- 1780060434
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- License
- H252373429364 (MI)
- Practice address
- 18 E Glenwood
Ecorse, MI 48229 - Phone
- (313) 908-7029
- NPI assigned
- Aug 5, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H252373429364 | MI | MD | Home Health Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | H252373429364 | MI | Yes |
Addresses
Primary practice location
18 E Glenwood
Ecorse, MI 48229
Mailing address
18 E Glenwood
Ecorse, MI 48229
Phone (313) 908-7029
NPI Registry JSON
{
"created_epoch": "1438732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1780060434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 E GLENWOOD",
"city": "ECORSE",
"state": "MI",
"postal_code": "48229",
"telephone_number": "313-908-7029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 E GLENWOOD",
"city": "ECORSE",
"state": "MI",
"postal_code": "48229",
"telephone_number": "313-908-7029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWKINS",
"first_name": "JASON",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-05",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "MI",
"license": "H252373429364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ecorse, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.