Active NPI
Melvin Gregory Hackler, D.C.
- Chiropractor
- Winslow, AZ
National Provider Identifier
1659417194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1049
- Practice address
- 218 N Williamson Ave
Winslow, AZ 86047-3721 - Phone
- (928) 289-2416
- Fax
- (928) 289-2416
- NPI assigned
- Jan 30, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1049 | AZ | Primary |
Addresses
Primary practice location
218 N Williamson Ave
Winslow, AZ 86047-3721
Mailing address
218 N Williamson Ave
Winslow, AZ 86047-3721
Phone (928) 289-2416
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AZ0085170 | Other | AZ | BLUECROSSBLUESHIELD IDEN |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1049 | AZ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659417194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "218 N WILLIAMSON AVE",
"city": "WINSLOW",
"state": "AZ",
"postal_code": "860473721",
"telephone_number": "928-289-2416",
"fax_number": "928-289-2416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 N WILLIAMSON AVE",
"city": "WINSLOW",
"state": "AZ",
"postal_code": "860473721",
"telephone_number": "928-289-2416",
"fax_number": "928-289-2416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKLER",
"first_name": "MELVIN",
"middle_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "1049",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHIELD IDEN",
"identifier": "AZ0085170",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winslow, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.