NICOLE R HAZELWOOD (CRNA) – Certified Registered Nurse Anesthetist, NPI 1558504076

NICOLE R HAZELWOOD (CRNA) is a healthcare provider. based in Farmington, Missouri. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 041429789 (IL). The NPI Number for NICOLE R HAZELWOOD (CRNA) is 1558504076

Main info

Female
Sole Proprietor
17 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE R HAZELWOOD (CRNA)
NPI
1558504076
Phone
(573) 760-8002
Address
1101 W Liberty St
Enumeration Date
14 April 2009
Last Update Date
8 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5733327881
Graduation Year
2009 (17 years ago)
PAC ID
4688726383
Group Practice PAC ID
4789099896
Professional Enrollment ID
I20090709000776
Address ID
MO637034902CA300XXRDXX504

Contacts

FHIR Endpoint
https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:17State licenses:2Other namesUpdated within 12 months

1,775 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MO

Provider Addresses for NICOLE R HAZELWOOD (CRNA)

  • 1101 W Liberty St

    Farmington, MO 636401921

    Phone: (573) 760-8002

    Type: Location

  • 216, Elm Street, Mid City, Jackson, Hinds County, Mississippi, 39203, United States

    JACKSON, MO 637551708

    Phone: (573) 576-1903

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-07-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090709000776ICertified Registered Nurse Anesthetist (Crna)MOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00910Anesthesia for other procedure on urinary system through urethra3128$0
00914Anesthesia for removal of prostate including use of an endoscope2117$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1514$0
View full utilization report →

Insurance plans in this area (ZIP 63640)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4789099896View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YMO
Certified Registered Nurse Anesthetist (Crna)MO

Reviews

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Frequently asked questions

What unique ID ties claims to NICOLE R HAZELWOOD (CRNA)?
NPI 1558504076 is assigned to NICOLE R HAZELWOOD (CRNA) under the national enumeration system.
Is NICOLE R HAZELWOOD (CRNA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize NICOLE R HAZELWOOD (CRNA)'s specialty in plain language?
Clinically, the directory lists NICOLE R HAZELWOOD (CRNA) with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Does NICOLE R HAZELWOOD (CRNA) practice in Missouri?
You will see Farmington, Missouri on file for NICOLE R HAZELWOOD (CRNA) alongside any extra practice locations.
Is NICOLE R HAZELWOOD (CRNA) a real provider?
This page reflects official NPPES data for NPI 1558504076. Always confirm identity and privileges with the practice and licensing boards.

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