Individual provider Active NPI

Redge Monte Hawkley, DPM

  • Podiatrist
  • Chico, CA
National Provider Identifier
1811971658
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E2424 Issued in CA
Practice address
1806 Foundation LN
Chico, CA 95928-9206
Phone
(530) 872-3038
Fax
(530) 872-8685
NPI assigned
Dec 5, 2005
Last updated
Feb 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E2424 CA Primary

Addresses

Primary practice location

1806 Foundation LN
Chico, CA 95928-9206

Mailing address

1806 Foundation LN
Chico, CA 95928-9206
Phone (530) 872-3038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100602000899 CA Practitioner - Podiatry 8426187303 Reassigns benefits to 1 organization
Practice locations: Paradise, CA

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plumas District HospitalGroup PAC ID 8224930466, shared by 4 NPIs, 40 clinicians

Practice addresses (Care Compare)

1065 Bucks Lake Rd
Quincy, CA 95971-9507
Phone (530) 283-2121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E2424CAMDPodiatrist
2424CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Glenn Medical Center, LLC CurrentSince Jan 25, 2010 Accepting new patients
Glenn Medical Center, LLC CurrentSince Jan 25, 2010 Accepting new patients

Locations

1133 W Sycamore St
Willows, CA 95988
Phone (530) 934-1800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1811971658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 FOUNDATION LN",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959289206",
            "telephone_number": "530-872-3038",
            "fax_number": "530-872-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 FOUNDATION LN",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959289206",
            "telephone_number": "530-872-3038",
            "fax_number": "530-872-8685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKLEY",
        "first_name": "REDGE",
        "middle_name": "MONTE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.