GEORGE HACKETT MS, ATC, CSCS, NPI 1457910416 — PHOENIX (AZ)

NPI 1457910416

0+ Years Experience Individual

GEORGE HACKETT MS, ATC, CSCS

06.12.2019
PROVIDER ENUMERATION DATE
06.12.2019
LAST UPDATE DATE
1457910416
NPI NUMBER

About GEORGE HACKETT

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

GEORGE HACKETT is a provider established in PHOENIX, AZ. The NPI number of GEORGE HACKETT is 1457910416 and was assigned on 06.12.2019. The practitioners primary taxonomy code is: 2081S0010X with license number: 348 AZ .

Mailing address

  • City: PHOENIX
  • State: AZ
  • Postal code: 850171097
  • Phone: 6026396038
  • Fax: 6025892305
  • Address: 3300 W CAMELBACK RD

Primary Practice Address

  • Region : PHOENIX, AZ
  • NPI : 1457910416
  • Phone : 6026396038
  • Fax : 6025892305
  • Postalcode : 850171097
  • Address : 3300 W CAMELBACK RD

Provider taxonomy - Physical Medicine & Rehabilitation

  • Taxonomy code: 2081S0010X
  • License number: 348
  • License state: AZ

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.

Contacts:

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  • GEORGE HACKETT MS, ATC, CSCS
  • Address : 3300 W CAMELBACK RD
  • Region : PHOENIX, AZ
  • NPI : 1457910416
  • Phone : 6026396038
  • Fax : 6025892305
  • Postalcode : 850171097

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address3300 W CAMELBACK RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePHOENIX
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code850171097
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6026396038
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6025892305
The fax number associated with the location address of the provider being identified.
NPI1457910416
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 12081S0010X
A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.
Provider Enumeration Date06.12.2019
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated06.12.2019
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)GEORGE HACKETT
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address3300 W CAMELBACK RD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NamePHOENIX
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code850171097
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6026396038
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number6025892305
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #12081S0010X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Physical Medicine & Rehabilitation
A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.
Provider License Number 1348
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1AZ
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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