Kerrian A Hazley, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME117182 Issued in FL

Practice address

362 State Highway 83
Defuniak Springs, FL 32433-3800

Phone

(850) 892-8015

Fax

(850) 892-8457

NPI assigned

Jun 25, 2009

Last updated

Apr 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Connecticut School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Florida Department of Health

  • Public Health or Welfare Agency
  • Defuniak Springs, FL
  • NPI 1790746535
  Medicare reassignment NPD
• Florida Department of Health

  dba Levy County Health Department

  • Public Health or Welfare Agency
  • Bronson, FL
  • NPI 1154395390
  NPD
• Florida Department of Health

  • Community Health Clinic/Center
  • Key West, FL
  • NPI 1639148919
  NPD (past)

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1689802993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 STATE HIGHWAY 83",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324333800",
            "telephone_number": "850-892-8015",
            "fax_number": "850-892-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 STATE HIGHWAY 83",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324333800",
            "telephone_number": "850-892-8015",
            "fax_number": "850-892-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZLEY",
        "first_name": "KERRIAN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "051502",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME117182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011940500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley Dianne Guillory, ARNP
• Gulf Coast Pain Consultants LLC
• Benjamin Fredrick Hammett, P.T
• Wendy M Harris, FNP-C
• Arjan Hayer
• Healthmark of Walton Inc (Healthmark Regional Medical Center)
• Healthmark of Walton Inc.
• Healthmark of Walton Rural Health Clinic Inc
• Healthy Transitions, LLC
• Lauran L Hebert

• Family Medicine Physician in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.