Active NPI
Jennifer Lynn Hazlak Montross, DC
- Chiropractor
- Hannibal, MO
National Provider Identifier
1023622925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2020019772
- Practice address
- 15 Northport PLZ
Hannibal, MO 63401-2269 - Phone
- (573) 221-2001
- Fax
- (573) 221-3316
- NPI assigned
- Sep 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2020019772 | MO | Primary |
Addresses
Primary practice location
15 Northport PLZ
Hannibal, MO 63401-2269
Mailing address
PO Box 1543
Hannibal, MO 63401-1543
Phone (570) 560-7552
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200923003008 | MO | Practitioner - Chiropractic | 7810316981 | Practice locations: Hannibal, MO |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- New York Chiropractic College, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
15 Northport PLZ
Hannibal, MO 63401-2269
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020019772 | MO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599523200000",
"number": "1023622925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1543",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634011543",
"telephone_number": "570-560-7552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 NORTHPORT PLZ",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634012269",
"telephone_number": "573-221-2001",
"fax_number": "573-221-3316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZLAK MONTROSS",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-08",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2020019772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hannibal, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.