R Mark Hazel, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

073631 Issued in GA

Practice address

1315 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501

Phone

(770) 848-6190

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mark.hazel@gclinic.emedpractice.direct-ci.com

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.

• Wallace Orthopaedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Rockwall, TX
  • NPI 1740306208
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673654400000",
    "number": "1023025632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 MEDLOCK BRIDGE RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 JESSE JEWELL PKWY NE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-848-6190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1404 River Pl Ste 401",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305175600",
            "country_code": "US",
            "telephone_number": "770-848-6190",
            "fax_number": "770-848-5367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "475 Philip Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300468736",
            "country_code": "US",
            "telephone_number": "770-995-3300",
            "fax_number": "770-995-0794",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZEL",
        "first_name": "R",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-01-14",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TN",
            "license": "MD47860",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "073631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhazel29485@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1315 Jesse Jewell Pkwy NE Ste 300",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer L Hayes, CRNA
• Andrew Haynes, M.S., LPC, NCC
• Cindy Haynes
• Martha D Haynes
• Jessica Shay Hays, DO
• Heather Jane Head, NP
• Stella Jeaneva Head, R.N.
• Wesley D Head, M.D.
• Healingstrands Salon & More
• Healthcare Specialty Transactions, LLC

• Orthopaedic Surgery Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Orthopaedic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.