Hazel Mae Hupeda Hofilena, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2005023980 Issued in MO

Practice address

616 N Main St
Mount Vernon, MO 65712-1004

Phone

(417) 499-1786

NPI assigned

May 14, 2007

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154536829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 W 5TH ST",
            "address_2": "SUITE D & E",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648012501",
            "telephone_number": "417-499-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 N MAIN ST",
            "city": "MOUNT VERNON",
            "state": "MO",
            "postal_code": "657121004",
            "telephone_number": "417-499-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFILENA",
        "first_name": "HAZEL MAE",
        "middle_name": "HUPEDA",
        "name_prefix": "Miss",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2005023980",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT 2861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carla Joyce Hall, M.S., L.P.C.
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• Frederick Crumpacker Husted, M.D.
• J. Warren Hildreth, Jr DDS PC of Missouri

• All providers in Mount Vernon, MO
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.