Individual provider Active NPI

Carol L Hulett, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Sierra Vista, AZ
National Provider Identifier
1750485470
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
CH042439 Issued in MI
Practice address
1951 Frontage Rd
Sierra Vista, AZ 85635-4606
Phone
(520) 458-0650
Fax
(520) 459-7030
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X CH042439 MI Primary

Addresses

Primary practice location

1951 Frontage Rd
Sierra Vista, AZ 85635-4606

Mailing address

302 El Camino Real
Ste 5
Sierra Vista, AZ 85635-2860
Phone (520) 458-4335

Other identifiers 1

IdentifierTypeStateIssuer
385927MedicaidAZ

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
CH042439MIMDSports Medicine (Orthopaedic Surgery) Physician

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285891200000",
    "number": "1750485470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 EL CAMINO REAL",
            "address_2": "STE 5",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352860",
            "telephone_number": "520-458-4335",
            "fax_number": "520-452-2232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 FRONTAGE RD",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856354606",
            "telephone_number": "520-458-0650",
            "fax_number": "520-459-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULETT",
        "first_name": "CAROL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2010-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MI",
            "license": "CH042439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "385927",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.

Verify at the official NPI Registry.