Hayden Blessing
Individual provider Active NPI Health Educator · Shawnee, OK
NPI 1205239290 · NPPES record last updated Oct 3, 2014
Key facts
- NPI
- 1205239290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Health Educator 174H00000X
- License
- 412707 (OK)
- Practice address
- 9 W Pulaski St
Shawnee, OK 74804-2839 - Phone
- (903) 815-8743
- NPI assigned
- Oct 3, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 412707 | OK | MD | Health Educator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 412707 | OK | Yes |
Addresses
Primary practice location
9 W Pulaski St
Shawnee, OK 74804-2839
Mailing address
9 W Pulaski St
Shawnee, OK 74804-2839
Phone (903) 815-8743
NPI Registry JSON
{
"created_epoch": "1412294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412294400000",
"number": "1205239290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 W PULASKI ST",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748042839",
"telephone_number": "903-815-8743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 W PULASKI ST",
"city": "SHAWNEE",
"state": "OK",
"postal_code": "748042839",
"telephone_number": "903-815-8743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLESSING",
"first_name": "HAYDEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-10-03",
"last_updated": "2014-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "OK",
"license": "412707",
"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. Record last updated by the provider on Oct 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.