India Shae Hawk, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT002168 Issued in GA

Practice address

616 Millstone Dr
Evans, GA 30809-5173

Phone

(843) 415-1240

NPI assigned

Sep 16, 2020

Last updated

Nov 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• India Shae Neal Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1861008880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 MILLSTONE DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308095173",
            "telephone_number": "843-415-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 MILLSTONE DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308095173",
            "telephone_number": "843-415-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWK",
        "first_name": "INDIA",
        "middle_name": "SHAE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT002168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OT002168",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INDIA",
            "last_name": "NEAL",
            "middle_name": "SHAE",
            "credential": "OT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• James David Harrover III, M.D.
• Patricia Hartlage, M.D.
• Kristi Hasten, O.T.
• Haven Medical Home PC
• Hawk Therapy Services LLC
• Thomas Hawk, PT
• Amanda Stroud Hayes
• Patricia Michelle Haynes
• Margo Louise Henderson, FNP
• Erica Sharday Henley

• Occupational Therapist in Evans, GA
• Providers in Evans, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.