Active NPI
Mary Ellen Haddock, CFTS
- Orthotic Fitter
- Ayden, NC
National Provider Identifier
1487950077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- License
- CFTS1166
- Practice address
- 131 Third Street
Ayden, NC 28513-7252 - Phone
- (252) 746-3492
- Fax
- (252) 746-4838
- NPI assigned
- Jan 31, 2011
- Last updated
- Jan 31, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | CFTS1166 | NC | Primary |
Addresses
Primary practice location
131 Third Street
Ayden, NC 28513-7252
Mailing address
131 Third Street
Ayden, NC 28513-7252
Phone (252) 746-3492
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 |
|---|---|---|---|
| CFTS1166 | NC | MD | Orthotic Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296432000000",
"number": "1487950077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 THIRD STREET",
"city": "AYDEN",
"state": "NC",
"postal_code": "285137252",
"telephone_number": "252-746-3492",
"fax_number": "252-746-4838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 THIRD STREET",
"city": "AYDEN",
"state": "NC",
"postal_code": "285137252",
"telephone_number": "252-746-3492",
"fax_number": "252-746-4838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HADDOCK",
"first_name": "MARY",
"middle_name": "ELLEN",
"credential": "CFTS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-31",
"last_updated": "2011-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "NC",
"license": "CFTS1166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ayden, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.