KELLY JO HAZUKA NP-C
NPI 1205188240
Nurse Practitioner - Family in Vienna, WV

Q: What is Kelly Hazuka's NPI number?

The NPI number for Kelly Hazuka is 1205188240. It was assigned to this individual provider in the NPPES registry on October 14, 2012.

Q: What is Kelly Hazuka's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Hazuka was last updated on October 5, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 14, 2012PECOS Enrolled

1500 GRAND CENTRAL AVE, SUITE 115, VIENNA, WV 26105(304) 489-3815 Get Directions Write a Review

NPPES record last updated: October 5, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Kelly Jo Hazuka Np-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY JO HAZUKA NP-C (NPI 1205188240) is an individual family provider in Vienna, West Virginia, licensed in West Virginia (58344) and active in the NPI registry since October 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Vienna.

NPPES Registry Identity

NPI1205188240

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKELLY JO HAZUKACredential: NP-C

Location Address1500 GRAND CENTRAL AVE, SUITE 115Vienna, WV 26105-1079

Mailing Address100 Avery Olivia Way Ste CFairmont, WV 26554-9375 · (304) 363-7000 · Fax (304) 366-7413

Phone(304) 489-3815

Sole ProprietorNo

Enumeration DateOctober 14, 2012

Last NPPES UpdateOctober 5, 2017

✔ NPI 1205188240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in WV · 58344

1500 GRAND CENTRAL AVE, Vienna, WV 26105

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Secondary Practice Location 1

Location 11500 Grand Central Ave, Suite 115Vienna, WV 26105-1079 · Phone (304) 489-3815

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Jo Hazuka Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26105 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.49 typical visit price

range $53.20 – $164.59

Typical copayment $20.87 (range $13.30 – $41.14)

Most-billed visit code 99203

Established Patient

$94.81 typical visit price

range $16.47 – $133.29

Typical copayment $23.70 (range $4.11 – $33.32)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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