Active NPI
Hazel Lynn Mitchell
- Rehabilitation Practitioner
- Las Vegas, NV
National Provider Identifier
1922449446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- 125406938-0005
- Practice address
- 9655 Las Vegas Blvd S
Apt. 275
Las Vegas, NV 89123-3386 - Phone
- (702) 677-2219
- NPI assigned
- Jul 12, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | 125406938-0005 | NV | Primary |
Addresses
Primary practice location
9655 Las Vegas Blvd S
Apt. 275
Las Vegas, NV 89123-3386
Mailing address
10624 S. Eastern Ave
Ste. a-134
Henderson, NV 89052
Phone (702) 677-2219
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 |
|---|---|---|---|
| 125406938-0005 | NV | MD | Rehabilitation Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373587200000",
"number": "1922449446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10624 S. EASTERN AVE",
"address_2": "STE. A-134",
"city": "HENDERSON",
"state": "NV",
"postal_code": "89052",
"telephone_number": "702-677-2219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9655 LAS VEGAS BLVD S",
"address_2": "APT. 275",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891233386",
"telephone_number": "702-677-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MITCHELL",
"first_name": "HAZEL",
"middle_name": "LYNN",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-12",
"last_updated": "2013-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NV",
"license": "125406938-0005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.