Organization Active NPI

Hazelwood Family Medicine, PLLC

  • Family Medicine Physician
  • Waynesville, NC
National Provider Identifier
1023124575
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HAZELWOOD FAMILY MEDICINE, PLLC
Practice address
1088 Brown Ave
Waynesville, NC 28786-1918
Phone
(828) 456-2828
Fax
(828) 456-8903
NPI assigned
Aug 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Linda Arrington Rich
Title
Insurance Secretary
Phone
(828) 456-2828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1088 Brown Ave
Waynesville, NC 28786-1918

Mailing address

1088 Brown Ave
Waynesville, NC 28786-1918
Phone (828) 456-2828

Other identifiers 2

IdentifierTypeStateIssuer
012KKOtherNCBCBS OF NC
89012KKMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051006000117 NC Part B Supplier - Clinic/Group Practice 0941225288 Receives reassigned benefits from 4 practitioners
Practice locations: Waynesville, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023124575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 BROWN AVE",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287861918",
            "telephone_number": "828-456-2828",
            "fax_number": "828-456-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 BROWN AVE",
            "city": "WAYNESVILLE",
            "state": "NC",
            "postal_code": "287861918",
            "telephone_number": "828-456-2828",
            "fax_number": "828-456-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZELWOOD FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "ARRINGTON",
        "authorized_official_title_or_position": "INSURANCE SECRETARY",
        "authorized_official_telephone_number": "828-456-2828",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "012KK",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012KK",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.