Individual provider Active NPI

Nanette Marie Hazelwood, BHRS

  • Contractor
  • Shawnee, OK
National Provider Identifier
1205101136
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
18906 13TH St
Shawnee, OK 74801-8688
Phone
(405) 250-9004
NPI assigned
Mar 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Primary

Addresses

Primary practice location

18906 13TH St
Shawnee, OK 74801-8688

Mailing address

18906 13TH St
Shawnee, OK 74801-8688
Phone (405) 250-9004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1205101136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18906 13TH ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748018688",
            "telephone_number": "405-250-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18906 13TH ST",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748018688",
            "telephone_number": "405-250-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELWOOD",
        "first_name": "NANETTE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "BHRS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-09",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.