Matthew Tyler Hazen, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2004029638 Issued in MO

Practice address

600 Manor Dr
Clarinda, IA 51632-2444

Phone

(712) 542-5164

NPI assigned

Feb 23, 2009

Last updated

Feb 23, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235347200000",
    "number": "1689814212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MANOR DR",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322444",
            "telephone_number": "712-542-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MANOR DR",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516322444",
            "telephone_number": "712-542-5164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZEN",
        "first_name": "MATTHEW",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MO",
            "license": "2004029638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Haffner-Szynskie, OTR
• Kirsten Noel Hamilton, ARNP
• Joshua Hardy
• Mitchell John Hargin, D.C.
• Michael Justin Hartman, PTA
• Herzberg Chiropractic, P.C.
• Kasey George Herzberg, D.C.
• Robert Jeffrey Hess, PT, DPT
• Stacey Lynn Hess, PMHNP
• Robbie Hickman, LMHC

• Physical Therapy Assistant in Clarinda, IA
• Providers in Clarinda, IA by specialty
• Physical Therapy Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2009; 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.