Active NPI
Stuart William Hazard, L.P.
- Psychologist
- Cambridge, MN
National Provider Identifier
1700105418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP5081
- Practice address
- 33861 Riverside Dr NE
Cambridge, MN 55008-7712 - Phone
- (763) 689-3833
- NPI assigned
- May 19, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP5081 | MN | Primary |
Addresses
Primary practice location
33861 Riverside Dr NE
Cambridge, MN 55008-7712
Mailing address
33861 Riverside Dr NE
Cambridge, MN 55008-7712
Phone (763) 689-3833
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
| License | State | Type | Specialty |
|---|---|---|---|
| LP5081 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274227200000",
"number": "1700105418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33861 RIVERSIDE DR NE",
"city": "CAMBRIDGE",
"state": "MN",
"postal_code": "550087712",
"telephone_number": "763-689-3833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33861 RIVERSIDE DR NE",
"city": "CAMBRIDGE",
"state": "MN",
"postal_code": "550087712",
"telephone_number": "763-689-3833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAZARD",
"first_name": "STUART",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "L.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-19",
"last_updated": "2010-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP5081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.