NPIMap

Individual provider Active NPI

Hazel Maria Ferrell, P.T.

  • Physical Therapist
  • South Williamson, KY
National Provider Identifier
1366519506
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003194 Issued in KY
Practice address
411 Central Ave
Suite 4
South Williamson, KY 41503-4149
Phone
(606) 237-0004
Fax
(606) 237-0330
NPI assigned
Nov 30, 2006
Last updated
Oct 17, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 003194 KY Primary
Physical Therapist 225100000X 001191 WV

Addresses

Primary practice location

411 Central Ave
Suite 4
South Williamson, KY 41503-4149

Mailing address

411 Central Ave
Suite 4
South Williamson, KY 41503-4149
Phone (606) 237-0004

Other identifiers 2

IdentifierTypeStateIssuer
000000258542OtherKYANTHEM BC BS
0158213000MedicaidWV

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

State licenses

LicenseStateTypeSpecialty
003194KYMDPhysical Therapist
001191WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health Care Services of Logan Inc Past Accepting new patients
Tug Valley Physical Therapy Physical Therapist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1366519506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 CENTRAL AVE",
            "address_2": "SUITE 4",
            "city": "SOUTH WILLIAMSON",
            "state": "KY",
            "postal_code": "415034149",
            "telephone_number": "606-237-0004",
            "fax_number": "606-237-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 CENTRAL AVE",
            "address_2": "SUITE 4",
            "city": "SOUTH WILLIAMSON",
            "state": "KY",
            "postal_code": "415034149",
            "telephone_number": "606-237-0004",
            "fax_number": "606-237-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRELL",
        "first_name": "HAZEL",
        "middle_name": "MARIA",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "003194",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "001191",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "000000258542",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0158213000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Williamson, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.