Individual provider Active NPI

Haley Layne Hatfield, MOT, OTR, MA, BCBA

  • Occupational Therapist
  • Kokomo, IN
National Provider Identifier
1639408057
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31004776A Issued in IN
Practice address
625 N Union Street
Kokomo, IN 46901-2907
Phone
(765) 252-0530
Fax
(765) 450-6664
NPI assigned
Dec 14, 2009
Last updated
Nov 17, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31004776A IN Primary
Pediatric Occupational Therapist 225XP0200X
Behavior Analyst 103K00000X

Addresses

Primary practice location

625 N Union Street
Kokomo, IN 46901-2907

Mailing address

3500 Depauw Boulevard
Suite 3070
Indianapolis, IN 46268-6135
Phone (855) 324-0885

Other identifiers 2

IdentifierTypeStateIssuer
201225780MedicaidIN
1-14-15211OtherBCBA CERTIFICATE

Other names 1

  • Haley Baker Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
31004776AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hopebridge, LLC Behavior Analyst 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, 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": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1639408057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 DEPAUW BOULEVARD",
            "address_2": "SUITE 3070",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462686135",
            "telephone_number": "855-324-0885",
            "fax_number": "765-450-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N UNION STREET",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469012907",
            "telephone_number": "765-252-0530",
            "fax_number": "765-450-6664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATFIELD",
        "first_name": "HALEY",
        "middle_name": "LAYNE",
        "credential": "MOT, OTR, MA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31004776A",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201225780",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA CERTIFICATE",
            "identifier": "1-14-15211",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HALEY",
            "last_name": "BAKER",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.