Active NPI
Charles R Hazle Jr., DPT
- Physical Therapist
- Berea, KY
National Provider Identifier
1295042703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 001909
- Practice address
- 202 Kidd Dr
Suite 3
Berea, KY 40403-7000 - Phone
- (859) 228-0201
- Fax
- (859) 228-0206
- NPI assigned
- Sep 3, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 001909 | KY | Primary |
Addresses
Primary practice location
202 Kidd Dr
Suite 3
Berea, KY 40403-7000
Mailing address
383 Corbin Center Dr
Corbin, KY 40701-1895
Phone (606) 526-2900
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PT Pros, Inc. | 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.
-
- Physical Therapist
- Lafayette, LA
- NPI 1164153839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283472000000",
"number": "1295042703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "383 CORBIN CENTER DR",
"city": "CORBIN",
"state": "KY",
"postal_code": "407011895",
"telephone_number": "606-526-2900",
"fax_number": "606-526-2901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 KIDD DR",
"address_2": "SUITE 3",
"city": "BEREA",
"state": "KY",
"postal_code": "404037000",
"telephone_number": "859-228-0201",
"fax_number": "859-228-0206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZLE",
"first_name": "CHARLES",
"middle_name": "R",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-03",
"last_updated": "2010-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "001909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berea, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.