HAWK HEALTH SYSTEMS LLC (NPI# 1881021681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881021681 |
| Entity Type | Organization |
| Organization Name | HAWK HEALTH SYSTEMS LLC |
| Other Organization Name | MADISON LIFE SPRING CLINIC |
| Practice Address |
248 Ne Hancock Ave Madison FL 32340-2560 |
| Mailing Address |
248 Ne Hancock Ave Po Box 173 Madison FL 32340-2560 |
| Practice Telephone | 8509739980 |
| Mailing Telephone | 8509739980 |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2014-10-06 |
| Authorized Official Name | THOMAS HARVEY GREENE III (MEMBER MANAGER) |
| Authorized Official Telephone | 8509739980 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9106677 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Madison Life Spring Clinic | Doing Business As Name - Organization |
| Street Address |
248 NE HANCOCK AVE |
| City | MADISON |
| State | FL |
| Zip Code | 32340-2560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184944068 | Thomas Harvey Greene IIi | Physician Assistant | 248 Ne Hancock Ave, Madison, FL 32340-2560 | 2010-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376016980 | Annie Laura Dyke | Registered Nurse | 213 Sw Third Ave, Madison, FL 32340 | 2019-01-07 |
| 1730698051 | Judith Khristian Sever-johnson | Registered Nurse | 218 Sw Third Avenue, Madison, FL 32340 | 2017-09-29 |
| 1265800437 | Maria Anchondo | Dentist | Ave. De La Raza #4722, Suite 3, Juarez, CHIHUAHUA 32340 | 2015-09-04 |
| 1508106063 | Family First Wellness Clinic, LLC | Family Medicine | 486 Sw Rutledge Street, Madison, FL 32340 | 2013-02-20 |
| 1306032073 | North Florida Pharmacy of Madison Inc. | Durable Medical Equipment & Medical Supplies | 139 Sw Macon St, Madison, FL 32340 | 2007-09-17 |
| 1295949444 | Roderick K Shaw IIi Dmd Pa | Dentist | 255 Ne Duval Ave, Madison, FL 32340 | 2007-05-09 |
| 1124159728 | Duramed Medical Services | Physiological Laboratory | 289 Sw Range Ave, Ste D, Madison, FL 32340 | 2007-03-08 |
| 1861595514 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 407 East Base St, Madison, FL 32340 | 2006-09-07 |
| 1194701862 | Mos LLC | Nurse Practitioner | 256 Sw Washington Ave, Madison, FL 32340 | 2005-12-15 |
| 1699248203 | Katelynn Mae Croft | Licensed Practical Nurse | 213 Sw Third Ave, Madison, FL 32340 | 2019-01-07 |
| Find all providers in zip 32340 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962804211 | Miranda Street Sudduth | Physician Assistant | 1607 Doctors Drive, Madison, MS 39110 | 2014-09-18 |
| 1184944068 | Thomas Harvey Greene IIi | Physician Assistant | 248 Ne Hancock Ave, Madison, FL 32340-2560 | 2010-06-02 |
| 1699001735 | Chad Jamison Gilliam | Physician Assistant | 1230 Slaughter Rd Ste C, Madison, AL 35758-5901 | 2009-10-24 |
| 1679763700 | Tamara A Melone | Physician Assistant | 2802 International Lane, Madison, WI 53708-0017 | 2007-07-25 |
| 1932237138 | Craig Michael Roberts | Physician Assistant | 2631 Chamberlain Ave, Madison, WI 53705-3717 | 2007-03-01 |
| 1639234610 | Sally-ann P Johannsen | Physician Assistant | 717 Hidden Cave Rd, Madison, WI 53717-2755 | 2006-12-27 |
| 1023105467 | Nicole Anna Hanson | Physician Assistant | 1617 Sherman Avenue, Madison, WI 53708-0017 | 2006-10-06 |
| 1730137548 | Renee A Knutson | Physician Assistant | 38 Hidden Hollow Trl, Madison, WI 53717-2501 | 2006-05-04 |
| 1669439329 | Deanna J Nakada | Physician Assistant | 750 University Row, Madison, WI 53705-1311 | 2006-04-27 |
| 1326002213 | Angela K Vitcenda | Physician Assistant | 701 Dane Street, Madison, WI 53713 | 2006-04-17 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.