Individual provider Active NPI

Gary L Hazelrigg, ATC

  • Athletic Trainer
  • Saint Joseph, MO
National Provider Identifier
1689619496
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
00032 Issued in MO
Practice address
802 N Riverside Rd
Saint Joseph, MO 64507-9794
Phone
(816) 271-4953
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 00032 MO Primary

Addresses

Primary practice location

802 N Riverside Rd
Saint Joseph, MO 64507-9794

Mailing address

2817 Lovers LN
Saint Joseph, MO 64506-1523
Phone (816) 364-5803

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

LicenseStateTypeSpecialty
00032MOMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689619496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 LOVERS LN",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645061523",
            "telephone_number": "816-364-5803",
            "fax_number": "816-279-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 N RIVERSIDE RD",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645079794",
            "telephone_number": "816-271-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELRIGG",
        "first_name": "GARY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "00032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.