Active NPI
Ian Hazelton, PT
- Athletic Trainer
- Manchester, CT
National Provider Identifier
1285604546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 000302
- Practice address
- 252 North Main Street
Eastern Rehabilitation Network 5TH Floor
Manchester, CT 06040 - Phone
- (860) 643-3562
- Fax
- (860) 643-3565
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 006992 | CT | |
| Athletic Trainer | 2255A2300X | 000302 | CT | Primary |
Addresses
Primary practice location
252 North Main Street
Eastern Rehabilitation Network 5TH Floor
Manchester, CT 06040
Mailing address
181 Patricia Genova Drive
Eastern Rehabilitation Network 5TH Floor
Newington, CT 06111
Phone (860) 667-5449
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000302 | CT | MD | Chiropractor |
| 006992 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Rehabilitation Network Headache Clinic | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- East Hartford, CT
- NPI 1205042793
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1285604546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 PATRICIA GENOVA DRIVE",
"address_2": "EASTERN REHABILITATION NETWORK 5TH FLOOR",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "06111",
"telephone_number": "860-667-5449",
"fax_number": "860-667-8416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "252 NORTH MAIN STREET",
"address_2": "EASTERN REHABILITATION NETWORK 5TH FLOOR",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "06040",
"telephone_number": "860-643-3562",
"fax_number": "860-643-3565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZELTON",
"first_name": "IAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CT",
"license": "006992",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CT",
"license": "000302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.