Organization Active NPI

Hazlewood Chiropractic Clinic LLC

  • Chiropractor
  • York, SC
National Provider Identifier
1033508940
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2989 Issued in SC
Legal business name
HAZLEWOOD CHIROPRACTIC CLINIC LLC
Practice address
622 E Liberty St
York, SC 29745-1605
Phone
(803) 818-5522
Fax
(803) 818-5523
NPI assigned
Jan 15, 2015
Last updated
Jan 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Authorized official

Name
Dr. Craig Alan Hazlewood, DCNPI 1245281609
Title
Owner
Phone
(803) 818-5522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2989 SC Primary

Addresses

Primary practice location

622 E Liberty St
York, SC 29745-1605

Mailing address

622 E Liberty St
York, SC 29745-1605
Phone (803) 818-5522

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150415002271 SC Part B Supplier - Clinic/Group Practice 0547588964 Receives reassigned benefits from 1 practitioner
Practice locations: York, SC

National Provider Directory

National Provider Directory

Locations

622 Liberty St E
York, SC 29745
Phone (803) 818-5522

Practitioners & affiliated clinicians

Practitioners 1

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": "1421280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1033508940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 E LIBERTY ST",
            "city": "YORK",
            "state": "SC",
            "postal_code": "297451605",
            "telephone_number": "803-818-5522",
            "fax_number": "803-818-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 E LIBERTY ST",
            "city": "YORK",
            "state": "SC",
            "postal_code": "297451605",
            "telephone_number": "803-818-5522",
            "fax_number": "803-818-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZLEWOOD CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "HAZLEWOOD",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-818-5522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.