Active NPI
Mickl D Hackett, CMS
- Case Manager/Care Coordinator
- Chesapeake, OH
National Provider Identifier
1699250480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 95 Private Drive 6999
Chesapeake, OH 45619-8026 - Phone
- (740) 532-3767
- Fax
- (740) 532-3385
- NPI assigned
- Sep 27, 2018
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | OH | Primary |
Addresses
Primary practice location
95 Private Drive 6999
Chesapeake, OH 45619-8026
Mailing address
214 S 4TH St
Ironton, OH 45638-1610
Phone (740) 532-3767
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Outreach Services, LTD | Past | Accepting new patients | |
| Spectrum Outreach Services, LTD | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Ironton, OH
- NPI 1013969666
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Ironton, OH
- NPI 1699254300
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538006400000",
"number": "1699250480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "214 S 4TH ST",
"city": "IRONTON",
"state": "OH",
"postal_code": "456381610",
"telephone_number": "740-532-3767",
"fax_number": "740-532-3385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 PRIVATE DRIVE 6999",
"city": "CHESAPEAKE",
"state": "OH",
"postal_code": "456198026",
"telephone_number": "740-532-3767",
"fax_number": "740-532-3385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKETT",
"first_name": "MICKL",
"middle_name": "D",
"credential": "CMS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-27",
"last_updated": "2018-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.